By Charanjeet Singh, Associate Professor, Radiology, Anschutz Medical Center CO, USA.
Prostate cancer is the second most common cancer in men worldwide. While many cases are treatable in early stages, advanced prostate cancer can be harder to manage. But there’s good news: a new kind of treatment, called PSMA therapy, is offering hope to men with difficult-to-treat prostate cancer.
Here’s what you need to know about this promising breakthrough.
What Is PSMA?
PSMA stands for Prostate-Specific Membrane Antigen. It’s a protein found on the surface of prostate cancer cells. Scientists discovered that PSMA is much more active in cancer cells than in normal ones. This makes it a perfect target for both detecting and treating prostate cancer. Think of PSMA like a flag waving on cancer cells, helping doctors to spot and attack them more precisely.
Better Scans, Better Detection: Before this treatment, finding where prostate cancer had spread in the body was tricky, especially when the cancer came back after treatment. But now, doctors can use PSMA PET scans—a special kind of imaging that lights up prostate cancer cells wherever they are.
This scan helps find even tiny tumors and allows doctors to plan more effective treatment. In fact, many men who’ve had a PSMA scan say it changed their treatment plan for the better.
PSMA Therapy: A Smart Way to Deliver Radiation. Once doctors know where the cancer is, they can use PSMA-targeted treatment, which acts like a guided missile.
Here’s how it works: A radioactive drug is attached to a molecule that sticks to PSMA. When injected into the body, this drug travels through the blood and attaches to prostate cancer cells. The drug then releases radiation, killing the cancer cells from the inside out.
The most common version of this treatment is called Lu-177 PSMA therapy, and it’s been a game-changer for men with advanced prostate cancer that hasn’t responded to other treatments.
Does It Work?
Yes. In a major international study called the VISION trial, men who received Lu-177 PSMA therapy lived longer and had fewer symptoms than those who got only standard treatment. Many also saw their PSA levels drop—a sign the cancer was shrinking.
Because of this, the U.S. Food and Drug Administration (FDA) approved Lu-177 PSMA therapy in 2022 for men with advanced prostate cancer.
What About Side Effects?
As with any treatment, there are some side effects, but they’re usually manageable. The most common are:
- Dry mouth (because the salivary glands also have PSMA)
- Fatigue
- Low blood counts (which can increase the risk of infection or bleeding)
Doctors check patients regularly and adjust treatment if needed. Some researchers are also testing ways to protect healthy parts of the body during treatment.
What’s Next?
Even more powerful forms of PSMA therapy are being tested. One version, using a radioactive element called Actinium-225, may work better in some patients. Scientists are also trying to combine PSMA therapy with other treatments—like hormone therapy or immunotherapy—to make it even more effective. Researchers hope that in the future, PSMA therapy could be used even earlier in the course of the disease, not just as a last resort.
A Personalized Approach:
One of the most exciting things about PSMA therapy is that it’s a form of personalized medicine. Before starting treatment, doctors use a PSMA scan to check if the patient’s cancer has enough PSMA. If the scan is positive, the patient is likely to benefit. This means doctors can tailor the treatment to the right patients at the right time.
Final Thoughts:
PSMA therapy is giving new hope to men with advanced prostate cancer. It’s smart, targeted, and backed by strong research. While it’s not a cure, it can help many men live longer and feel better, even when other treatments have stopped working.
If you or a loved one is facing prostate cancer, ask your doctor about PSMA scans and whether this new treatment might be an option. Using the cutting-edge PSMA PET imaging, doctors can precisely detect prostate cancer spread, even at low PSA levels, enabling earlier and more accurate treatment planning. For eligible patients with advanced or metastatic prostate cancer, the center offers PSMA-targeted radioligand therapy, such as Lutetium-177 PSMA, which delivers targeted radiation directly to cancer cells. This personalized approach improves outcomes while minimizing side effects. Science is moving fast, and for many patients, PSMA therapy is opening doors that were once closed. This type of scan and treatment is now available at multiple government and private centers in India.
The results of his research presented during 56th Annual Conference of Society of Nuclear Medicine India (SNMICON 2024) and the 29th Annual Conference of SNMI Southern Chapter (SNMISC 2024), Coimbatore. For more information, talk to a cancer specialist or visit trusted sources like the American Cancer Society or National Cancer Institute.