Lutetium-177 PSMA Therapy
Lutetium-177 PSMA therapy is a targeted radioligand treatment for advanced, metastatic castration-resistant prostate cancer. A radioactive molecule that seeks out PSMA, a protein found on prostate-cancer cells, is given by intravenous infusion in cycles. It delivers radiation directly to tumors wherever they have spread in the body.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
Lutetium-177 PSMA therapy is a form of targeted radioligand therapy for advanced prostate cancer. Lutetium-177, a radioactive isotope, is chemically attached to a molecule that binds PSMA (prostate-specific membrane antigen), a protein expressed on the surface of most prostate-cancer cells. Given by intravenous infusion in cycles by the nuclear medicine team, the radioligand travels through the bloodstream, locks onto PSMA-positive cells wherever they have spread, and delivers radiation from inside the tumor while largely sparing healthy tissue. It is typically offered to men with metastatic, castration-resistant prostate cancer after standard treatments. Suitability is confirmed beforehand with a PSMA-PET scan that shows the cancer takes up the tracer.
International patients are supported throughout by a dedicated coordinator. Our nuclear medicine specialists can carry out a remote second-opinion review of your PSMA-PET scans, pathology and records before you travel, and you receive a transparent, itemized cost estimate in advance so you can plan with confidence.
Who is a candidate?
- Men with metastatic, castration-resistant prostate cancer (cancer that has spread and progressed despite hormone therapy)
- Patients whose disease is PSMA-positive on a PSMA-PET scan, confirming tumors take up the tracer
- Those who have already received standard treatments such as hormone therapy and chemotherapy
- Patients with adequate kidney function and acceptable blood counts confirmed by laboratory tests
- Men seeking a targeted option that reaches cancer throughout the body, including bone and lymph-node metastases
- Patients well enough to travel and complete a short radiation-protection stay for each cycle
What happens
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Preparation
Eligibility is confirmed with a PSMA-PET scan to verify the cancer is PSMA-positive, along with blood tests to check kidney function, blood counts and PSA. Your records are reviewed by the nuclear medicine team, who explain the plan and radiation-safety precautions.
- 2
During treatment
Lutetium-177 PSMA is given slowly through an intravenous infusion while you stay comfortable and awake. Because the medicine is radioactive, you remain in a dedicated radiation-protection room for a short stay so emissions can subside safely. The treatment is repeated in cycles, usually up to six, spaced several weeks apart.
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Afterwards & results
Between and after cycles, your team monitors response with PSA blood tests and follow-up imaging, and may use a post-therapy scan to confirm the radioligand reached the tumors. Results and next steps are reviewed with you, and findings can be shared with your home physician.
Benefits
- Targets PSMA-positive cancer cells throughout the body, reaching metastases other treatments may miss
- Delivers radiation from inside the tumor while limiting the dose to surrounding healthy tissue
- Given as an intravenous infusion without surgery or general anesthesia
- Often eases cancer-related pain and can lower PSA in men who respond
- Suitability is confirmed in advance by a matching PSMA-PET scan, so treatment is personalized
Risks & considerations
- Tiredness or fatigue, which may build over successive cycles
- Dry mouth or reduced saliva, because salivary glands also take up the radioligand
- Lower blood counts in the weeks after treatment, which can raise the risk of infection, bruising or bleeding, so your blood is checked regularly between cycles
- Possible effects on kidney function, plus nausea that is usually manageable with medication
- Dry or watery eyes, as the radioligand can also affect the tear glands
- A small long-term risk of a blood or bone marrow disorder, such as myelodysplastic syndrome or, rarely, a later leukemia, which is uncommon but which your team monitors for
- Contact your medical team straight away if you develop a fever, chills or other signs of infection, or any unusual bruising or bleeding, as these can be signs of low blood counts that need prompt attention
Conditions this treats
Where it is performed
This procedure is delivered by our Nuclear Medicine & Theranostics Department.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Lutetium-177 PSMA Therapy — frequently asked questions
It is mainly for men with advanced, metastatic castration-resistant prostate cancer whose disease is PSMA-positive on a PSMA-PET scan, usually after standard treatments such as hormone therapy and chemotherapy have been tried.
It is given as an intravenous infusion by the nuclear medicine team. Most patients receive cycles spaced about six to eight weeks apart, usually up to six in total, with the exact number tailored to how you respond and tolerate treatment.
The PSMA-PET scan confirms your cancer cells carry the PSMA target and take up the tracer. This shows the therapy is likely to reach the tumors and helps your team decide if you are a suitable candidate.
Yes. Because the medicine is radioactive, you stay briefly in a dedicated radiation-protection room after each infusion so emission levels can fall safely before discharge. The stay is usually short, and the team explains simple precautions to follow afterwards.
Yes. Our nuclear medicine specialists offer a remote second-opinion review of your PSMA-PET scans, pathology and medical records before travel, so we can confirm whether the therapy is appropriate and plan your visit before you commit to coming.
After reviewing your records, we provide a transparent, itemized estimate covering scans, each treatment cycle, the radiation-protection stay and follow-up, so you know the expected cost before you travel. Your coordinator can clarify any item.
Related treatments
Considering lutetium-177 psma therapy?
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