The word cure seems to be disappearing from talk about cancer. These days, doctors are more likely to talk about cancer control, rather than cure. This is partly because cancers that used to be a death sentence are now seen as a chronic disease that patients can live with for years, thanks to recent target and-manage therapies that control ongoing problems as they arise.
However, when prostate cancer (PCa) is diagnosed and treated early, 95% of patients appear to be “cured”. This means there are no future signs that their disease is back. They go about their lives, and ultimately die from other causes.
Tragically, some men are diagnosed when their cancer has already begun to spread (metastasize) to other parts of the body. While there is still no cure for metastatic prostate cancer (mPCa), there is a new method for destroying PCa that has colonized bone and/or other organ tissues. It is a hope-filled, exciting new treatment approach called theranostics, a term that’s a blend of therapy and diagnostics.
The new treatment, called 177Lu-PSMA-617, is described in a Memorial Sloan Kettering newsletter as using “…a molecule that selectively seeks out and attaches to a specific protein on the cancer cell surface called PSMA (prostate-specific membrane antigen). The technology delivers radiation that damages DNA and destroys the cancer cell.”
This approach evolved from PSMA-PET scanning to detect prostate cancer recurrence, which is often metastatic. Since PCa cells have 100-1000 times more PSMA on their surface than normal cells, tiny radiotracer molecules stick to them like glue, and light up on PET scans. This reveals the location of even very small sites of PCa tumors. So, it was logical that if imaging could take advantage of PSMA to target cell locations, the next step would be harnessing this technology to deliver a lethal blow to the cells themselves.
The radiopharmaceutical manufacturer of 177Lu-PSMA-617, Novartis, states, “After administration into the bloodstream, 177Lu-PSMA-617 binds to prostate cancer cells that express PSMA, a transmembrane protein, with high tumor-to-normal tissue uptake.. Once bound, emissions from the radioisotope damage tumor cells, disrupting their ability to replicate and/or triggering cell death.” A clinical trial called VISION, a phase 3 study, enrolled 381 patients with PSMA-detectable mPCa that no longer responded to androgen deprivation therapy. The investigators found, “The PSMA-targeted radioligand 177Lu-PSMA-617 prolonged overall survival and delayed imaging-based progression when added to standard care in patients with PSMA-expressing metastatic castration-resistant prostate cancer.”
177Lu-PSMA-617 is not yet a complete cure, but it offers longer life. With the abundance of research occurring, a definitive cure may be just around the corner. It’s worth it to extend a man’s lifetime in hopes that that corner is turned as soon as possible.
Written by
Fash01
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There was a recent thread started by LearnAll asking if Lu-177 was being over-hyped a bit. When it is written about (by Dr. Sperling, and Novartis itself) in purely glowing terms, as above, I think the answer may be "yes."
The above passage might be edited to be a bit more realistic, by way of qualifying some of the observations and inserting the word "some," like this:
"... there is a new method for destroying [SOME] PCa that has colonized bone and/or other organ tissues"
"... since [SOME] PCa cells have 100-1000 times more PSMA on their surface than normal cells"
“... 177Lu-PSMA-617 prolonged overall survival and delayed imaging-based progression when added to standard care in [SOME] patients with PSMA-expressing metastatic castration-resistant prostate cancer.”
"177Lu-PSMA-617 is not yet a complete cure, but it offers longer life [for SOME]
"... it’s worth it to extend [SOME] men’s lifetimes..."
There is no cure. The best can do is "manage it" until we die of something more pleasant (Eg suffocation in the breasts of a well endowed woman). Every treatment will fail in the end.
Wean only hope that there is a cure sooner than later, been in this fight almost 6 years now. As the song goes I’m not afraid of dying I just don’t want to die right now 🙏🙏🙏🙏
Woody Allen, when he did stand up comedy in the 1960s, had this line: “I’m not afraid of dying, I just don’t want to be there when it happens.”
This sounds like an ad for a drug/doctor without all the legal jargon. This is also coming from a radiologist? with limited exposure to the world of advanced prostate cancer treatments. As noahware mentions, SOME is missing from a lot of statements. Do you have experience with this treatment or advanced prostate cancer? Your bio is empty.
Greetings and thank you Fash01. (Now for the stuff we all hate).
Would you please be kind enough to tell us your bio. Age? Location? When Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?
ALL INFO IS VOLUNTARY, but it helps us help you and helps us too. When you respond, you might want to copy and paste it in your home page for your use and for other members’ reference.
Fash, Several guys here on HU have gone thru the LU-177 treatment. About 1/3 did well, 1/3 had little change, and 1/3 had horrible experience or could not finish due to toxicity. Once again, early appears better than later in the PCa journey (a recurring theme with many treatments). Far from a panacea. Now a couple of guys have gone thru LU-J591, which may be more effective, although not yet FDA apprvd in US.
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