How is Radium 223 (Xofigo) Used for Prostate Cancer?

It is thought that radium 223 is a useful treatment for advanced prostate cancer that has metastasized to the bones.

A medical practitioner might inject radioactive radium 223 dichloride, sometimes known simply as radium 223, into your bloodstream to treat prostate cancer that has metastasized (spread to your bones). It can be purchased under the Xofigo brand.

Eliminating prostate cancer cells from your bones aids in preventing the cancer from growing or harming healthy tissues.

Continue reading to find out more about the usage of radium 223 for prostate cancer, its mechanism of action, and what to anticipate from radium 223 treatment.

When is radium 223 used for prostate cancer?

Treatment for advanced prostate cancer that has gone to the bones involves radium 223.

It might also be useful in the subsequent circumstances:

Prostate cancer that is resistant to castration has not responded well to hormone therapy.
Chemotherapy treatments have too many unfavourable side effects and are too strong for your body.
Your bones are the only parts of your body where the cancer has spread.
Abiraterone is not a sort of hormone therapy that you are taking to treat prostate cancer.

How radium 223 works for prostate cancer

One variety of radium that emits alpha particles is radium 223. In cells composed of two linked strands of DNA, alpha particles can split the strands apart. The impacted cells are often killed by this.

Because radium 223 mimics calcium, it is frequently useful in treating cancer that has spread to the bones.

In regions where cancer cells have caused harm or injury, calcium frequently accumulates. In regions where there are a lot of cancer cells, injected radium 223 can also accumulate by functioning similarly to calcium. Radium 223 can destroy cancer cells while preserving neighbouring healthy tissues because its alpha particles don't go very far.

What is the success rate of radium 223 for prostate cancer?

Radium 223 was given to 48 patients with prostate cancer in a 2018 study, and 62.5% of those patients felt less pain than they had before treatment.

In addition, radium 223 may help you have a better long-term prognosis if your prostate cancer has progressed.

Radium 223 side effects in patients with prostate cancer

Radium 223 side effects for prostate cancer have been shown to include the following:

changes in overall health and quality of life
bone pain
reduced bone marrow
short-term damage to sperm
low red blood cell count (anemia)
difficulty with blood clotting (thrombocytopenia)

Receiving radium 223 in preparation for prostate cancer

Before beginning radium 223 treatment for prostate cancer, you might need to:

get blood tests
get a bone scan
stop taking calcium supplements
Make arrangements for a friend or family member to drive you to and from the appointment.

Your doctor would probably advise you to wait six months before getting pregnant to give your sperm time to repair and regenerate.

Radium 223 procedure for prostate cancer

Here are some things to anticipate both before and after a prostate cancer radium 223 operation.

Before the procedure

You will be called into a private treatment room by a medical practitioner. Typically, anaesthesia is not required, nor is it necessary for you to change into a hospital gown.

During the procedure

Your arm near the injection location will be cleaned by a medical practitioner, who will also apply a tourniquet to aid in locating your veins.

After that, a tube known as a cannula will be inserted into your vein. Radium 223 is put into a vial and inserted through the cannula into your circulation.

The entire dose of radium 223 will be put into your body in a matter of minutes.

After the procedure

After the injection, you can normally go right away if everything seems OK.

Your physician might advise you to follow these instructions during the first few days following an injection:

To remove radium 223 from your body, drink water.
To prevent radioactive particles from leaving the toilet, sit down when you urinate.
When wiping after having a bowel movement, think about wearing gloves.
Make two toilet flushes to remove radioactive particles.
Following each use, disinfect the toilet seat.
Urine or excrement-splattered garments should be washed separately from other apparel.

Recovering from the procedure

Injections of radium 223 had little effect on recovery.

Generally speaking, unless you experience significant side effects or an adverse reaction to the injections, you can immediately resume your regular activities.

According to the injection's prescribing literature, it is often advised that you take contraception for six months after treatment with radium 223 since foetal development problems could occur.

How much does radium 223 cost?

A six-cycle course of radium 223 treatment costs between $43,000 and $57,000, according to a 2023 study out in the Netherlands.

The majority of the costs are covered by most health insurance programmes. Prostate cancer is covered by Xofigo under the majority of government health programs, including Medicare.

Alternatives to radium 223 for prostate cancer

For advanced prostate cancer, some substitutes for radium 223 or combinations of therapy using radium 223 include:

When used alone or in conjunction with radium 223 is enzalutamide (Xtandi).
Oral prednisone and abiraterone (Zytiga), each used separately and not in conjunction with radium 223

Takeaway

If you're still having symptoms of prostate cancer, such as bone pain, talk to your doctor about this treatment, especially if earlier therapies haven't been successful.