Radium-223 Dichloride Therapy (NR223)

Please complete your appointment details from your appointment letter and bring this leaflet with you.

Please ensure you have your next appointment booked before leaving.

The leaflet aims to explain your treatment and give you some general information. We are happy to provide additional information and our contact details are on the back of this leaflet.

What is ‘nuclear medicine’?

Nuclear medicine is the medical use of radioactive substances for diagnosis and treatment of diseases. Your doctor will discuss your treatment with you, and will consider its benefits before sending us your referral.

What is Radium-223 Dichloride?

Radium-223 dichloride mimics the calcium found in bones. It is injected into a patient, to reach the bone the cancer has spread to. There it emits short-range radiation (alpha particles) which kills the surrounding tumour cells.

This is used to treat adults with prostate cancer, a cancer of a gland of the male reproductive system that does not respond to treatment to reduce male hormones. It is only used when the disease has spread to the bone but is not known to have spread to other internal organs, and is causing symptoms (pain).

The recommended dosing schedule is one injection every four weeks for six months, for a total of six injections. The use of Radium-223 dichloride beyond six injections has not been studied.

How is the treatment carried out?

• On your first appointment you will be seen by a doctor and the treatment will be explained.
• After seeing the doctor, and on subsequent appointments, a nurse will give you a radioactive injection into vein, usually in your arm (similar to a blood test).
• The dose you receive depends on your body weight. The recommended dose of Radium-223 dichloride is 55 kBq* per kilogram body weight. Therefore, if your weight changes by more than 10% please inform the department.

* a kiloBecquerel is a unit of radioactivity.

Do I need to prepare for the treatment?

You can eat and drink as usual.

Make sure you keep your blood cell count monitoring appointments and tell your doctor about any symptoms or signs of low blood cell counts such as shortness of breath, tiredness, bleeding (such as bruising), or infection (such as fever).

How long will the test take?

The treatment takes about 30 minutes.

Will it hurt?

The injection is no worse than a blood test.

Side effects

Very common (more than 1 in 10 people):

• Diarrhoea (2-4 days)
• Nausea (1-2 days)
• Thrombocytopenia (decrease in the number of blood platelets).

Common (Less than 1 in 10 people):

• Decrease in the number of white blood cells (leukopenia)
• Decrease in the number of neutrophils, a type of white blood cell (neutropenia), which may lead to an increased risk of infection)
• Decrease in the number of red and white blood cells and blood platelets (pancytopenia)
• Injection site reactions (such as redness of the skin, pain and swelling)

Uncommon (may affect up to 1 in 100 people):

• Decrease in the number of lymphocytes, a type of white blood cell (lymphopenia)

Can you drive after treatment?

Yes you can drive as usual after the treatment.