A new and promising way to treat cancer by delivering radiation from the inside out

When most people hear “radiation” as a cancer treatment, they think of external radiation therapy, which is irradiated from a machine that irradiates cancer. However, radiopharmaceutical therapy attacks cancer from the inside out.

When most people hear “radiation” as a cancer treatment, they think of external radiation therapy, which is irradiated from a machine that irradiates cancer.

But a new targeted therapy called radiopharmaceutical therapy (RPT) takes the machine out of the equation and uses radioactive atoms delivered by an intravenous drip to bind to and kill specific cancer cells. can.

Dr. Michael Morris is the Medical Director of Advanced Molecular Imaging and Therapies in Glen Burnie, Maryland. He is also Vice President and Scientific Program Chair of the Middle East Chapter of the Society for Nuclear Medicine and Molecular Imaging (SNMMI).

He said that external beam radiation therapy has proven to be very effective in killing cancer, although it has some side effects.

“It’s targeted from outside the patient, but only to a specific area, and everything within that area receives a universal dose of radioactivity,” Morris said. “Because the radiation has to travel through the body before it reaches the area of ​​interest, some radiation also reaches the surrounding tissue.”

Side effects of radiation may include loss of taste, skin changes, hair loss, diarrhea, and sexual problems, depending on the part of the body being treated.

Just as targeted drug therapy focuses on specific mutations in cancer cells and does not provide as broad an effect as chemotherapy, RPT is not limited by the range of the beam from the machine.

With RPT, drugs can deliver radiation therapy directly and specifically to cancer cells, killing tiny deposits of cancer cells that build up throughout the body while reducing the risk of side effects. increase.

“There are no machines,” Morris said. “It allows us to deliver treatment anywhere in the body. This is different from external beam irradiation, which targets only certain areas or regions.”

After a patient is diagnosed with cancer, doctors can use imaging, often PET/CT scans, to determine whether the patient will benefit from RPT, Morris said.

For example, doctors can use radioactive tracers to target and destroy PSMA, a protein on the outside of prostate cancer cells.

“Cancer that expresses a PSMA target can be treated anywhere in the body because the target is in the cancer cell itself,” said Professor Morris. “So whether it’s the bone, the lymph node, the liver or the pelvis, it needs to be treated.”

Applying radiation directly to cells is nothing new. Radioactive iodine has been used to treat thyroid cancer since the 1940s.

“I mean, we’ve been using that remedy in that particular area for 80 years,” Morris said. “And thyroid cancer was one of the first cancers that medicine could actually treat. Thanks to our RPT therapy, it is present but invisible during surgery. “

Morris added that RPT is now being used for prostate cancer, and other cancers that respond well to the treatment are being investigated.

“For example, there are two clinical trials going on here looking at indications for lung cancer.”

Morris also said that RPT could be used to track the success of radiation treatments.

“After treatment, we can see that by imaging the treatment itself inside the patient’s tumor, and we can also see how the treatment that is not bound to the tumor is flushed out of the body.” he said. “We can actually quantify, or measure, the amount of radioactivity delivered to tumors and healthy tissue.”

“That’s why we call this branch of nuclear medicine ‘theranostics,’ because it has both therapeutic and diagnostic aspects,” Morris said.

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