Theranostics is a new approach to cancer care that combines the words “diagnostics” and “therapeutics.” Theranostics uses molecular imaging tests, like positron emission tomography (PET), to identify cancer cells — even tiny deposits of cells. Then, radiopharmaceutical medications target the cancer cells while leaving normal cells alone.

This type of radiation therapy can offer you earlier diagnosis, more personalized treatments, and better outcomes.

Theranostics can be an effective radiation therapy for certain types of cancers, such as metastatic prostate cancer and thyroid cancer. It may offer you earlier diagnosis, an alternative to other treatments, more personalized treatment, and better outcomes.

Why Choose Us

  • Increased quality of life: Using theranostics, our experts can treat your cancer effectively without disrupting your quality of life. Our diagnostic and therapeutic techniques are noninvasive, which often means fewer, less serious side effects.
  • Patient-first approach: Our doctors collaborate to determine your best treatment options. We give you options, and then involve you in a treatment-planning process that focuses on your mind, body, and spiritual health.
  • Latest clinical trials: Our experts are always working to translate research directly into better care for you. New clinical trials using theranostics offer you access to the latest treatments available.
  • First proton therapy clinical program: As the first in the nation to offer proton therapy at a hospital-based treatment center, our cancer experts have a deep knowledge of the most advanced radiation therapy available.
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PSMA Therapy

Prostate-specific membrane antigen (PSMA) is a protein produced by metastatic prostate cancer cells. PSMA therapy is an injectable radiation treatment that targets and destroys those cells.

PSMA therapy benefits men with metastatic prostate cancer whose cancer progresses even after surgical or chemical castration and chemotherapy.

PSMA for Diagnosis

Your urologist or oncologist may refer you for a diagnostic PSMA PET scan to determine if you have metastatic prostate cancer. You’ll have an intravenous (IV) injection of a radioactive imaging isotope, called a radiotracer. If prostate cancer cells are present, the radiotracer attaches to the PSMA protein on the cancer cells, making them visible on the PET scan.

PSMA for Treatment

If the PET scan and your staging status qualify you for therapy, on a later date you will have an IV injection of a therapeutic radioactive isotope, or radiopharmaceutical, to treat the cancer. Because the isotope has the same molecular makeup as the PSMA PET scan, it attaches to the cancerous cells and kills them with radiation. 

PSMA therapy takes about an hour and you can go home immediately afterward. Because your body still has radioactive molecules in it, you should avoid close contact with people or sharing items that could be contaminated with radiation. Your system will eliminate the radioisotope in about a week. We’ll provide complete instructions for radiation precautions after your procedure.

Iodine Theranostics

Iodine is essential to hormone production in the thyroid gland, and the thyroid readily absorbs iodine from the food we eat. Using a radioactive form of iodine, we can target and destroy traces of thyroid cancer.  

Iodine therapy is mainly used to treat papillary thyroid cancer, but may also be used for other types (such as follicular thyroid cancer). It’s often used to target any remaining thyroid cancer cells after surgery has partially or mostly removed the thyroid gland. It can even find and destroy cancer cells that have spread to other parts of the body, such as the lymph nodes.

Radioiodine for Diagnosis

Your first visit with us usually comes after you’ve had part or most of your thyroid surgically removed following a cancer diagnosis. We’ll discuss how the treatment works, the effects of radioactive iodine (radioiodine) on your body, and the safety requirements you’ll need to follow.

Before treatment can begin, you’ll need to alter your diet for several weeks to reduce the amount of normal iodine in your system. You’ll also need to stop using thyroid hormone pills for up to several weeks.

After this time, you’ll come in for another visit and drink a small amount of tasteless, odorless radioiodine before returning home. About a week later, we’ll see you again and use a scan to look at where the radioiodine has been absorbed. This will allow us to determine the exact stage your cancer is in, based on where the cancer cells are located in your body.

Radioiodine for Treatment

One of the advantages of iodine theranostics is that treatment usually involves nothing more than drinking the initial dose of radioidine. After you return home from your staging appointment, the radioiodine you already drank continues to seek and destroy cancer cells. If your cancer has spread from the thyroid gland, you may have to come in for another round of treatment in approximately six months. In most cases, though, you will only need one dose and you can return to your endocrinologist or ENT surgeon for blood test monitoring to make sure the treatment is working as intended.

The procedure is noninvasive and usually allows you to return home immediately. The radioactive nature of the treatment can present some challenges, though. At home, you’ll need to follow strict isolation procedures for the first few days so you don’t expose others to radiation. Isolation will continue with less strict procedures for several weeks after that. We’ll help you understand these procedures and implement a plan that works with your living situation. You can find helpful information on isolation and a range of other topics from the American Thyroid Association.

Over half of patients experience some kind of side effects from the treatment. These can include swelling of your salivary glands, dry mouth, discomfort with swallowing, a change or reduction in taste, or nausea. Side effects are usually mild and last several days to several weeks but in some cases can persist longer.

Lutathera & NETSPOT Theranostics

Lutathera is the brand name for a medicine used in theranostics to treat certain neuroendocrine tumors that originated below the diaphragm. Often, these tumors originate from the pancreas or gut and may have spread to any number of locations in the body. People who receive Lutathera have a much higher chance of survival.

A different form of the medicine, known as NETSPOT, is first used to locate (or spot) these neuroendocrine tumors (NETs).

NETSPOT for Diagnosis

During your first visit with us, you’ll receive the NETSPOT medicine and receive a PET scan. The NETSPOT helps evaluate any neuroendocrine tumors throughout your body and locates them on the scan. We’ll use the results of this scan as a baseline for the progression of your cancer, which we can compare to future scans.

You’ll then start a long-acting somatostatin analogue, if you are not already on one, which is a drug which suppresses neuroendocrine function. The somatostatin may improve your symptoms and slow tumor growth. You’ll then receive regular PET scans until NETSPOT shows that your cancer has progressed despite the effects of the somatostatin.  

Lutathera for Treatment

If a NETSPOT PET scan shows your cancer has started progressing, you’ll come into our offices for a consultation. We’ll review your imaging and labs to make sure you meet the criteria for treatment with Lutathera and speak with you about the radiation safety risks and benefits. Because your somatostatin can affect treatment, we’ll set a date to begin treatment based on when it wears off — usually around 30 days.  

Treatment consists of four doses, each delivered two months apart. You’ll spend most of the day receiving fluids, amino acids, and Lutathera through an IV. The amino acids we use are a special compound that goes beyond minimum FDA guidelines to protect your kidneys and greatly reduce the chance of serious nausea during treatment.

At the end of each treatment day, you’ll receive a dose of your somatostatin drug and return when the medicine wears off for your next dose of the Lutathera.  You’ll go home and follow certain isolation procedures for about two weeks, including sleeping in a bed alone.

Take the Next Step

When you are diagnosed with cancer, you want treatment from an expert team you can trust. You may be referred to the Loma Linda University Cancer Center by your primary care physician or an emergency department. For more information, please call 1-800-78-CANCER (800-782-2623).