Treatments (nuclear medicine)

This is a treatment for over active thyroid disease.

Radium 223 (trade name Xofigo) is used to treat prostate cancer which has spread to the bones. It aims to slow the growth of the cancer in the bones, and to help with symptoms such as pain.

Xofigo contains radioactive material (radium dichloride) which acts in a similar way to calcium, so it becomes concentrated in areas of the bone which are rapidly growing or rebuilding themselves. It is powerful radiation but can only travel short distances, killing off cancer cells in the bone while only causing minimal damage to the surrounding healthy tissue.

Because it targets cells which use calcium, Xofigo only treats the cancer in the bones and not the prostate itself.

Your treatment will be given as a series of small injections, each one like a blood test, in six doses over six months.

The side effects are milder than standard chemotherapy. You should experience nothing more than mild nausea, diarrhoea and tiredness for a few days after each injection.

The short-lived radiation in Xofigo is contained within your body, which means you can go home immediately after each injection.

Iodine-131 is used to treat malignant thyroid disease. It is radioactive, so when it settles in the thyroid cells, it reduces the number of cells that work.

You will be given an appointment for a clinic in nuclear medicine to speak to a consultant. We will plan your treatment to give you time to think about it, and make any arrangements that you need to.

You should have a low-iodine diet for up to two weeks before your treatment, and for a few days afterwards. This is to reduce the amount of iodine stored in your body, and helps to increase the effectiveness of the treatment.

You will have your treatment in a special private room on the therapy ward. The iodine-131 is in a capsule, which you swallow through a large straw. After your treatment, you need to stay in the private room for around two to four days until the radioactivity has declined. Our staff will take measurements to check how this is going.

Most people tolerate this treatment very well. At most, it might make you feel slightly nauseous or tired for a day or two.

We use selective internal radio therapy (SIRT) to treat malignant liver tumours. These tumours may have originally developed in the liver, or might have spread to the liver from somewhere else in the body.

We inject millions of tiny resin beads (less than the width of a human hair) into a major blood vessel supplying the tumour. These beads contain yttrium 90, which sends out beta particles. Beta particles produce powerful radiation which can only travel short distances, killing off cancer cells but only causing minimal damage to the surrounding healthy tissue.

Once injected, the beads travel along the blood vessel to the tumour area where they become embedded in the tiny capillary vessels. The treatment works in two ways; the radiation from the yttrium damages the tumour cells, and the beads block the blood vessels which cuts off the oxygen supply to the tumour.

To prepare for your treatment, we will perform an angiogram (this is a type of x-ray) to look at the blood supply to your liver and to identify the main blood vessel suppling the tumour. A low dose of a radioactive tracer (usually an albumin particle) is injected along the vessel to mimic the way SIRT beads are trapped. We can then use a gamma camera to see the location of the tracer in the liver, and calculate the exact dose of yttrium 90 beads to use.

On the day of your treatment, we will inject the SIRT beads into blood vessels we identified. You will then be transferred to nuclear medicine for a scan to locate the position of the SIRT beads. Although the beta particles cannot be measured, they cause a low level scatter radiation that we can see using a gamma camera.

After the treatment and scan you must stay in a private room for 24 hours until the radioactivity has reduced.

This treatment can make you feel slightly nauseous or tired for a day or two.

Lutetium 177 dotatate is used to treat malignant neuroendocrine tumours.

Dotatate targets specific tumour cells by binding to receptors on the cells. By attaching a radioactive material to dotatate, we can also bind this radioactive material directly onto the tumours. This is known as targeted therapy. The radioactive material used in this therapy is Lu177 dotatate, a gamma and beta particle emitter. Beta particles produce powerful radiation which can only travel short distances, killing off the cancer cells but only causing minimal damage to the surrounding healthy tissue.

You will usually have an octreotide or PET dotatate study before we offer this therapy to check if it is suitable for you.

Your treatment will be given in a special private room on the therapy ward. We will give you the lutetium 177 dotatate as an intravenous infusion (into a vein), which will take about 20 minutes. After your treatment, you need to stay in the private room overnight until the radioactivity has declined. Our staff will take measurements to check how this is going.

You might feel a bit nauseous or tired for a day or two after your treatment.