Radium-223 Therapy, Xofigo, What to Expect, Theranostics, Theranostics Singapore, Cancer Treatment, Patient Information, Dr Andrew Tan

What Is Radium-223 Therapy (Xofigo)? 

Radium-223 Therapy (Xofigo) is a form of targeted radioactive therapy. It is a type of radioactive treatment that targets sclerotic bony metastases.

What Is Prostate Cancer?

Prostate cancer is one of the most common cancers among men. Approximately 1 in 9 men will be diagnosed with prostate cancer in their lifetime, and it is the second leading cause of cancer-related death in men in the United States. 

While most prostate cancers are early stage at diagnosis, a significant portion will have regional or distant metastases.

What to Expect Before Treatment With Radium-223 Therapy (Xofigo)?

Our doctor must confirm that you have prostate cancer through existing studies and tests. Once this is confirmed, our doctor typically requests a series of tests to assess your general health.

You will need a bone scan that demonstrates bony metastases. 

You may also be asked to stop taking calcium before the treatment session. Our doctor will sit down with you to look at your medical history, explain the severity of the disease and everything related to the treatment. Take advantage of this moment to clarify any possible concerns you may have.

What Will My Radium-223 Therapy (Xofigo) Treatment Schedule Look Like?

Our treating doctor will explain the damage to your body caused by prostate cancer and the consequences of not being treated. They will also explain the program you must follow to achieve the best possible treatment outcome with Radium-223 Therapy (Xofigo). 

Other information that will be provided to you will be regarding possible adverse effects and the therapeutic measures that you can take to minimise these effects. 

What happens after treatment and the prevention measures to keep in mind will be explained in detail. 

Finally, you may be advised to stop any other radiotherapy or chemotherapy treatments that you are undergoing before starting Radium-223 Therapy (Xofigo).

What to Expect During Treatment With Radium-223 Therapy (Xofigo)?

The treatment program for Radium-223 Therapy (Xofigo) consists of intravenous administration (peripheral route in one arm) of the drug. 

Treatment typically comprises 4-6 sessions, with a period of 4 weeks between each one.

The drug will be administered directly in the vein, and the procedure is typically fast and painless. 

Before each session, a blood sample will be drawn to evaluate health parameters and haematological conditions.

How Long Does Treatment With Radium-223 (Xofigo) Take?

Radium-223 Therapy (Xofigo) is a relatively quick procedure, which will take no more than half an hour. The application of the intravenous drug takes no more than a minute.

As mentioned, additional time will be required while the nurse places the catheter for the intravenous line and its subsequent removal.

What to Expect After Treatment With Radium-223 Therapy (Xofigo)?

After Radium-223 Therapy (Xofigo) treatment, there will be low-grade radioactivity from the patient. Small amounts of radioactivity may be present in the urine and stools. 

One of the advantages of this type of treatment is that it will not be necessary to avoid contact with family and friends since the radiation levels received is very low. Still, the doctor will give you a card stating that you have received such treatment.

How Long Before I Can Be Discharged After Treatment With Radium-223 (Xofigo) Therapy? 

As it is an outpatient procedure, discharge after intravenous application will be quick – it will not take more than a couple of hours for the first side effects to subside. Generally speaking, within 1-2 hours, you may be on your way home.

How Will I Feel After Treatment With Radium-223 (Xofigo) Therapy? 

Once the treatment is complete, you may feel somewhat dizzy or, in some cases, fatigued. It is normal to have some discomfort since you have received radiation treatment. However, try not to worry as these symptoms should disappear relatively quickly. In case of persistence, consult our doctor.

This type of therapy for prostate cancer is one of the few that generates minimal side effects. Among them, we have:

  • Nausea
  • Diarrhoea
  • Anaemia
  • Oedema in the ankles and wrist 

If you have had a therapy session and you have persistent side effects, feel dizzy, confused, and weaker than normal, or have any other symptoms that are not expected, notify our doctor immediately.

Any prolongation of the symptoms may be a cause for alarm, so you must notify your medical care immediately. Our doctor will take the necessary therapeutic measures to correct any discomfort as your body responds to the treatment.

Radiation Safety Precautions

As mentioned above, there will be small traces of radiation particles in the urine, blood, and faeces. Therefore, you must comply with the following radiological safety conditions:

  • Flush the toilet twice and wash your hands properly.
  • Wash clothes and sheets stained with vomit, blood, urine, and faeces separately. Handle with gloves.
  • Stay well hydrated before and after therapy.
  • Use a condom when having sex to prevent your partner from becoming pregnant (it is dangerous because of the effects of radiation) – this recommendation is valid for six months.
  • Do not expose your partner to pre-seminal fluid and semen, as it may contain radioactive particles.

What Questions Should I Ask My Doctor?

If you are feeling overwhelmed by your diagnosis, here are some questions that you can ask your doctor. 

  • How do I know if I am a candidate for Radium-223 Therapy (Xofigo)?
  • Is it an outpatient procedure? Why?
  • How many therapy sessions with Radium-223 Therapy (Xofigo) do I need?
  • What happens if I don’t follow through with all the Radium-223 Therapy (Xofigo) sessions?
  • Is it mandatory to stop other methods of therapy like chemotherapy?
  • Should I stop taking dietary supplements that contain calcium?
  • Should I take any security measures with my family and partner?
  • Can I have sex?
  • What do I do if I have blood in my urine?
  • Is it mandatory to have blood tests before each session?
  • Could I end up being sterile?