Prostate Cancer Treatment with Lutetium-177 PSMA (program ID: 408538)
University Hospital Saarland Homburg
Samer EzziddinSpecialized in: nuclear medicine
Department of Nuclear Medicine
The Department of Nuclear Medicine annually provides treatment to more than 620 patients with metastatic prostate cancer. During the therapy a high-quality radioactive lutetium isotope (Lu-177) preparation is used. Lu-177 specifically bounds to the PSMA-containing tumor cells and metastases and kills them. Doctors of the department under the guidance of Prof. Dr. med. S. Ezziddin offer effective treatment with a minimal complications rate.
- Initial presentation in the clinic
- history taking
- general clinical examination
- laboratory tests:
- complete blood count
- biochemical analysis of blood
- TSH-basal, fT3, fT4
- PSA blood test
- tests for urogenital infections
- indicators of inflammation
- indicators of blood coagulation
- ultrasound scan of the urogenital system
- renal scintigraphy
- PSMA PET-CT (if indicated)
- PSMA treatment
- full body scintigraphy after 24 hours
- full body scintigraphy after 48 hours
- symptomatic treatment
- cost of essential medicines
- nursing services
- elaboration of further recommendations
- stay in the hospital with full board
- accommodation in 2-bedded room
How program is carried out
During the first visit, the doctor will carry out a general physical examination and go through the results of previous laboratory and instrumental tests. After that, you will undergo the necessary additional tests such as the assessment of liver and kidney function, scintigraphy of the skeleton and salivary glands, PSMA PET / CT. This will allow the doctor to assess how effective PSMA therapy with Lutetium-177 will be and how well you will tolerate it. Also, the doctor will calculate your individual dosage of the radionuclide.
PSMA therapy with Lutetium-177 is carried out via intravenous administration of a solution with the radioactive isotope Lutetium-177. The solution is injected through a catheter. This is a short procedure, as the infusion usually takes no more than 20 minutes.
During the procedure, you will need to apply cooling bags to the salivary glands, as Lutetium-177 partially accumulates in the salivary glands, affecting their function and causing dry mouth. You will also receive intravenous saline solutions to protect your kidneys.
After the infusion of Lutetium-177, you will stay in a specially equipped (radiation-shielded) ward for 48 hours. The drug is quickly excreted by the kidneys, and after 48 hours you will no longer be dangerous to others. During these 48 hours, you can read, use a mobile phone, tablet or computer – all these devices will not be a source of radiation in the future.
Follow-up examinations include whole-body scintigraphy or computed tomography in 24 hours and 48 hours after the procedure. Based on the results of the examination, the doctor will determine whether one procedure is enough for you, or whether you will need to visit the hospital again. As a rule, 1-2 procedures are required for achieving a stable positive result. Procedures are carried out with an interval of 8 weeks.
- Medical records
- MRI/CT scan (not older than 3 months)
- Biopsy results (if available)
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About the department
The Department of Nuclear Medicine at the University Hospital Saarland offers patients the full range of modern diagnostic and treatment methods in the field of nuclear medicine. The department is known as the largest medical facility of its kind in the South-West Germany. Treatment of thyroid diseases and oncological pathologies belongs to the main priorities of the department. The department is led by Prof. Dr. med. Samer Ezziddin.
Prof. Dr. Samer Ezziddin is an international expert in the treatment of neuroendocrine tumors and targeted radionuclide therapy. He also specializes in radioembolization, thyroid diagnostics and multimodal imaging with the use of PET-CT and SPECT-CT.
The examination to detect oncological diseases involves the use of PET diagnostics, which, if necessary, can be conducted with the participation of specialists in internal medicine, surgical oncology and radiation therapy. Another important examination is the diagnosis of sentinel lymph nodes, which has been conducted for many years on the basis of the Department of Dermatology for melanoma treatment, as well as on the basis of the Breast Center for the diagnosis of sentinel lymph nodes in mammary gland diseases.
Along with the diagnostics, the department also deals with treatment. It uses radioactive drugs that accumulate in the affected organ and provide targeted treatment without harming the rest of the body. Other treatment options include, for example, radioimmunotherapy in lymphomas, pain therapy in skeletal metastases, as well as selective internal radiation therapy for liver metastases.
Thanks to the competent and responsible attitude of the department's specialists, the dose of radiation, in most cases, is minimal, since there are used only small amounts of radioactive substances that quickly decay and can be eliminated from the body. Therefore, with virtually all methods of nuclear medicine, there are no side effects.
The diagnostic range of the department:
- FDG-PET scan
- PSMA PET/CT
- PET/CT to detect amyloid protein (for example, in Alzheimer's disease)
- FET PET-CT in brain tumors
- PET/CT to identify somatostatin receptors
- FDOPA PET/CT
- Sodium Fluoride PET/CT
- Choline PET/CT
- And other diagnostic options
The therapeutic range of services includes the following options:
- Radioiodine therapy
- Radiosynoviorthesis (RSO)
- Radio-phosphorous therapy for bone metastases
- Selective internal radiation therapy
- Peptide receptor targeted radiation therapy
- Therapy for bone metastases
- Targeted radionuclide PSMA-therapy with Lu-177 isotope in metastatic prostate cancer
- Targeted radionuclide PSMA-therapy with Ac-225 isotope in metastatic and recurrent prostate cancer
- And other therapeutic options
- Study in Human Medicine at the Goethe University Frankfurt.
- 1997 German and American State Examination.
- 1998 Internship in Endocrinology and Hepatology at the University Hospital Cologne.
- Board certification in Nuclear Medicine, Department of Nuclear Medicine at the University Hospital Bonn.
- 2006 Senior Physician, Department of Nuclear Medicine of the University Hospital Bonn.
- 2008 Leading Physician and Deputy Head of the Department of Nuclear Medicine at the University Hospital Bonn.
- Completion of the part-time Master's program "Clinical medical technology" at the Rheinische Friedrich-Wilhelms University in Bonn.
- 2014 Appointment as an Acting Head of the Department of Nuclear Medicine at the University Hospital Saarland.
- Professorship in Nuclear Medicine at the Saarland University.
Photo of the doctor: (c) Universitätsklinikum des Saarlandes