Radionuclide Therapy

Radionuclide Therapy: A Personalised Approach to Targeting and Destroying Cancer Cells

Radionuclide therapy, also known as targeted radiotherapy or molecular radiotherapy, is a type of cancer treatment that utilises radioactive substances to target and destroy cancer cells. This therapy has emerged as a powerful and versatile tool in managing various malignancies, offering a personalised approach to cancer treatment. With fewer side effects than traditional external beam radiation and chemotherapy, radionuclide therapy provides a promising option for cancer patients.

Mechanism of Action

Radionuclide therapy delivers targeted radiation to cancer cells with the help of a radiopharmaceutical agent. The radiopharmaceutical, which is a compound containing a radioactive isotope, is administered into the patient’s bloodstream, either orally or intravenously. This compound then selectively binds to specific proteins or receptors present on the surface of cancer cells.

Once bound, the radiopharmaceutical emits radiation, typically in the form of beta particles or alpha particles. These particles travel a short distance, causing localised damage to the DNA of cancer cells while minimising harm to surrounding healthy tissue. The targeted destruction of cancer cells leads to cell death and, eventually, tumour shrinkage.

Types of Radionuclide Therapy

Several types of radionuclide therapy are classified based on the radioactive isotopes used and their mechanisms of action. Some common examples include:

  • Radioiodine therapy (I-131) is the most well-known radionuclide therapy and is primarily used to treat thyroid cancer. The thyroid gland takes the radioactive iodine, including cancerous thyroid cells, and the emitted radiation destroys these cells.
  • Peptide receptor radionuclide therapy (PRRT): PRRT targets neuroendocrine tumours by using radiolabeled peptides that specifically bind to receptors on tumour cells. The most common isotopes used in PRRT are lutetium-177 (Lu-177) and yttrium-90 (Y-90).
  • Radioimmunotherapy: This therapy utilises monoclonal antibodies engineered to recognise specific proteins in cancer cells. To deliver targeted radiation, these antibodies are labelled with radioactive isotopes, such as yttrium-90 (Y-90) or iodine-131 (I-131).

Benefits and Limitations

Radionuclide therapy offers several advantages over traditional cancer treatments. As a targeted therapy, it reduces damage to healthy tissue and can lead to fewer side effects. Additionally, it can be used as a standalone treatment or in conjunction with other therapies, such as chemotherapy or surgery.

However, radionuclide therapy also has its limitations. Not all cancers can be treated with this method, and sometimes, the radiopharmaceuticals do not effectively target the cancer cells. The treatment’s efficacy may also be limited by tumour size and location.

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