Cardinal Santos Medical Center, one of the Philippines’ leading hospitals, is highlighting the latest in prostate cancer treatment to its patients this Prostate Cancer Awareness Month. Prostate cancer is the third most frequent cancer among middle-aged men[1], and since Father’s Day is coming up, it is especially important for fathers to prioritize their prostate health to ensure they are able to spend more happy and healthy years with their families.
Cardinal Santos is one of only two hospitals in the country that offers Radionuclide Therapy, or Lutetium Prostate-Specific Membrane Antigen (Lutetium PSMA). Cardinal Santos also offers prostate cancer screening procedures and treatments for patients who have already been diagnosed, and other more conventional treatments such as hormonal therapy and chemotherapy.
“Essentially, Lutetium PSMA is a liquid radiation which is given intravenously to the patient,” said Dr. Andrew Dominic Kalaw, a Nuclear Medicine specialist at Cardinal Santos’ Radiology department. “If a prostate cancer patient has already been through more common treatments like hormonal therapy or chemotherapy, but the cancer is still metastasizing or progressing, they can be offered Lutetium PSMA as another form of treatment, which is what we’re already doing here in Cardinal Santos.”
Kalaw finished his medical residency training in Radiology at Cardinal Santos. He then pursued his fellowship in Positron emission tomography (PET) in Switzerland, and then in Singapore for theranostics, particularly in the use of advanced medicines and other radiopharmaceuticals that are very limited in the Philippines, like Lutetium PSMA.
“Lutetium PSMA is a new and rare treatment in the Philippines because it is very hard to procure logistically,” said Kalaw. “It is not produced locally, so we have to order the medicine from abroad, in Europe specifically. We outsource it, we order it through another company who synthesizes the Lutetium PSMA locally, and then it is delivered to us on the day we need to use it.”
While it is a fairly new treatment being offered at the hospital, Cardinal Santos already had its first Lutetium PSMA patient, which turned out to be a success. “The patient tolerated the procedure well,” Kalaw noted. “He was admitted overnight and was discharged the next day with no complications.”
According to Kalaw, the side effects of Lutetium PSMA are fairly benign. “Short-term side effects within the first 24 hours may include nausea, lightheadedness, and in some cases abdominal pain, but that is very rare,” he said.
Lutetium PSMA is also safe to use alongside oral or injectable hormonal therapies; the same cannot be said, however, for chemotherapy. “There is a synergistic effect when given in combination with hormonal therapies, meaning the effect may be more beneficial. But when it comes to chemotherapy, it is the opposite, so we require the patient to stop chemo treatments at least 4 weeks prior.” The reason for this, said Kalaw, is that they need certain parameters, such as blood count, creatinine count, platelet count, kidney and liver health to be on a normal level, and chemotherapy lowers these levels.
Regardless, Lutetium PSMA is a relatively safe treatment, which can be done in three to four sessions. “In my experience, I have seen patients admitted in wheelchairs for their first Lutetium PSMA treatment session,” Kalaw shared. “And then in succeeding sessions, they already felt well enough to go by themselves.”
Prostate cancer manifests itself through symptoms such as needing to urinate more frequently, having weak or erratic flow during urination, feeling the bladder has not been fully emptied after urination, and having blood show up in the urine or semen.[2] However, these symptoms do not necessarily mean the individual has cancer, as they are very common occurrences in men as they get older.
As there is such a fine line between non-cancerous developments in the prostate and prostate cancer symptoms, it is strongly recommended that men start screening procedures for the disease such as prostate-specific antigen testing (PSA) as early as 40 years old, especially those men with family history of prostate cancer.
The challenge now is to raise awareness for the treatment here in the Philippines. “Urologists might be aware of the treatment with regards to prostate cancer, but because of the limited practice and lack of experience, doctors might not know what to expect in terms of safety for their patients. This causes a barrier for referrals,” Kalaw stated. “So our next goal should be informing them that it is available at Cardinal Santos, and that it is safe to offer. I am very confident in saying this because of the favorable outcome of our first Lutetium PSMA patient.”
“I am very glad that Cardinal Santos gave 100 percent of its support and belief in this procedure, because now we are able to perform it here in the hospital. The potential of helping many patients through this is significant,” Kalaw concluded. “Sometimes people are afraid of what they do not understand, but with proper communication, we will be able to further this treatment in our institution.”
Radionuclide Therapy or Lutetium PSMA is available at the Nuclear Medicine department of Cardinal Santos’ Radiology unit. Worry less about prostate cancer in your golden years and spend it happily with your loved ones instead by booking a consultation with Cardinal Santos’ urologists today.
For more information about the programs and services that CSMC offers, please visit https://cardinalsantos.com.ph/. CSMC is also on Facebook, like and follow them at www.facebook.com/CardinalSantos.
[1] https://www.bworldonline.com/health/2022/06/15/454849/knowing-prostate-cancer/
[2] https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq
