In an interview about radium 223 with Medscape Medical News, Dr. Vapiwala pointed out that radium-223 is the first alpha-emitter to reach the market, and described it as a “breakthrough for radiopharmaceuticals” and “another breakthrough for prostate cancer,” as it joins several other agents that have recently been approved for this disease.
She characterized the treatment, Radium-223 has having an “elegant way of working. She explained that its similarity to calcium means that it naturally travels to the bone and is easily absorbed. After the radium has been absorbed by the bone it releases short-range high-energy alpha particles that are toxic and cause double-stranded DNA breaks.
The elegance comes in not only by the targeting method, but also because the alpha particles effect any area far from where they are absorbed limiting the damage to other tissue.
The half-life of radium-223 is short (roughly 11 days), so the radioactivity decays rapidly meaning there are no special precautions needed by the man
Because of the fast half-life of the radium, the unused drug soon becomes inactive and can be thrown away with regular waste and men do not have to limit their contact with others. Additionally, no special shields or equipment are required for providers. In most cases radium-223 can be administered in any facility that already has radionuclide capabilities. Radiation oncologists or nuclear medicine physicians can also administer it after a limited amount of training training.
Radium 223 has been shown to be safe as well as well tolerated All of this and it improved survival and provided symptom control and pain relief
Dr. Vapiwala said, “The real-world applicability of this new therapy is undeniable….Hormone-refractory prostate cancer that has metastasized to the bones can be a debilitating and, in many cases, life-threatening.”
The clinical trial excluded men with visceral metastases, but it is possible that men with soft tissue mets may still be allowed to use the treatment. In addition, there is a real possibility that radium-223 will eventually be moved earlier and earlier to first-line therapy in patients with either castrate-sensitive or castrate-resistant disease and osseous metastases.
Joel T. Nowak, M.A., M.S.W.