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What are the cancers treated by Nuclear Medicine therapies?

Ans : The following cancers are treated by Radionuclide therapies :
Thyroid Cancers, Neuroendocrine tumours, Neuroblastomas and extraadrenal phaeochromocytomas, Hepatocellular cancer and Prostate cancer.
In addition, radionuclide therapies are ued for pain palliation in patients with bone metastases.

What role does Radionuclide therapy play in Thyroid cancer?

Ans : Radioiodine therapy is administered to postoperative cases of differentiated Ca Thyroid who have residual/recurrent functioning thyroid tissue in neck or those who have evidence of metastases.
The dose of radioiodine depends on the histopathology and staging of the cancer.

Are neuroendocrine tumours also treated with radioiodine ? Is it a new therapy ? Does it have any prerequisite ?

Ans : Metastatic neuroendocrine tumours are treated with Lu-177 DOTATATE therapy. This therapy is being administered in India since 2011, Inlaks and Budhrani Hospital being one of the pioneers in this field in India.
A somatostatin receptor scan (SSTR Scan) has to be done prior to commencent of this therapy.

What are the options available for neuroblastomas and extraadrenal phrochromocytomas ?

Ans : Patient diagnosed to have Medullary Thyroid cancer, neuroblastomas and extra-adrenal pheochromocytoma can be considered for I-131 MIBG therapy provided that they have tracer avid lesions on I-131 MIBG scan.

Is Nuclear Medicine therapy being used in Prostate cancer on regular basis ?

Ans : Lu-177 PSMA therapy is being done on an experimental bais at some centers in India.
However, Strontium-89m/Samarium-153 palliative pain therapy is being administered to patients with skeletal metastasis with good results.

What is the role of Nuclear Medicine in Hepatocellular cancer (HCC)?

Ans : Y-90 microspheres therapy is given in HCC in collaboration with an interventional radiologist. To know if a particular patient would benefit from the therapy, you need to consult a Nuclear Medicine physician with all your reports.

What is the cost of these therapies?

Ans : The cost of Radionuclide therapies varies over a wide range.
this is because some of the radionuclides are "made in india" by BARC while some are imported. Pleae contact the Nuclear Medicine Department to know the cost of your therapy.

Can one get the therapy in general ward to minimize the cost?

Ans : Radionuclide therapies mentioned above, except for the palliative pain therapies and HCC therapy, have to be carried out in a high dose therapy isolation ward approved by AERB for the purpose. these therapies cannot be carried out in any other ward of the patient's choice.