Update – The clinical trial is over for quite awhile now and the FDA has approved PRRT. Well, here we go again. I have a new plan to fight my cancer and it looks like I will be heading to Texas. It appears that the FDA will (or has already) approved a second clinical trial at Excel Diagnostics for PRRT. That is great news for us Americans. Now, instead of traveling to Europe you can partake in a PRRT clinical trial in America and save thousands of Dollars. Not to mention that you will work with local, English speaking doctors which makes life easier. You will miss out on the beauty of Europe though. If you are interested then you can contact:
Therapy Patient Coordinator
Excel Diagnostics and Nuclear Oncology Center
9701 Richmond Avenue, Suite 122
Houston, TX 77042
DIRECT PH: 713.341.3203
MAIN PH: 713.781.6200 X3203
It Is Expensive
My understanding is that PRRT is currently only used as a treatment for carcinoid cancer and Nets in Europe. This can cost about $80,000.00 to $100,000.00 dollars when you include treatment, travel, lodging and meals. That is because you must make multiple trips for multiple treatments. Now that America is an option those expenses should be cut in half. At least, that is what I am estimating. I am hoping to spend less than $15,000.00 per trip.
An Introduction To PRRT
PRRT stands for Peptide Receptor Radionuclide Therapy. When I explain it to friends I don’t say radionuclide I just say radiation therapy. As I understand it, patients can only get this therapy if they are Octreotide positive. In other words, if your tumors bind to Octreotide then you are Octreotide positive. I had an Octreotide scan when I was first diagnosed which showed that I am.
Give Me A “P”
Octreotide is a man made version of the hormone somatostatin. The Octreotide is the Peptide and the “P” in the PRRT.
Sandostatin® (octreotide acetate) Injection, a cyclic octapeptide prepared as a clear sterile solution of octreotide, acetate salt, in a buffered lactic acid solution….. Read More
Give Me An “R”
If you are Octreotide positive then that means that your tumors “bind” to the peptide being used called Octreotide. Think of these receptors as little magnets that attract the Octreotide.
The cells in most neuroendocrine tumors have an abundance (called an overexpression) of a specific type of surface receptor—a protein that extends from the cell’s surface—that binds to a hormone in the body called somatostatin. Read More
Give Me Another “R”
Once it is determined that your tumors are Octreotide positive the doctors bind a radioactive particle to the Octreotide. Depending on how well your tumors bind to, or attract, the Octreotide the tumor cells are then irradiated and begin dying.
Peptide receptor radionuclide therapy (PRRT) combines octreotide with a radionuclide (a radioactive substance) to form highly specialized molecules called radiolabeled somatostatin analogues or radiopeptides. These radiopeptides can be injected into a patient and will travel throughout the body binding to carcinoid tumor cells that have receptors for them. Once bound, these radiopeptides emit radiation and kill the tumor cells they are bound to. Read More
(Update – Thanks to Gary Murfin) My understanding is that PRRT is administered with various radioactive substances such as lutetium 177 (177Lu), yttrium 90 (90Y) and indium 111 (111In). As I understand it the LU-177 is being used in Texas and is one of the is less destructive to surrounding tissues than some of the other choices. If you’re ready to have your mind blown, here’s a video on LU-177.
Give Me A “T”
It is a therapy and not a cure. My understanding is that the common response to this treatment (LU-177) is that it halts the tumor growth for about 3 years. They measure this treatment from the time treatment ends I think. Of course, some patients see no change and others see dramatic tumor shrinkage and some patients even see the tumors die away. As they say, it affects each person differently.
My understanding is that if you partake of the clinical trial in Texas then you must go 3 to 4 times to be injected about every 6 to 9 weeks but that all depends on the condition of the patient of course. Another benefit of this PRRT trial is that it is not a localized therapy such as in embolization (click the link to learn more) but is systemic. So, if you have stage 4 carcinoid cancer like myself this will treat all of the tumors at the same time.
Note, there are other protocols, liver directed therapies, risks, side effects and other issues to consider when making decisions like these but I hope that this article has given you an overview of what PRRT is and how it works.
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