Having lutetium therapy

Lutetium therapy is a treatment called a targeted radionuclide therapy for a group of rare cancers called neuroendocrine tumours. The treatment targets cancer cells and gives a high amount (dose) of radiation directly to the tumour. 

Before you have lutetium therapy

Before you have lutetium therapy, we check if this is a suitable treatment for you.

You need to have a special type of scan called a DOTATATE PET (positron emission tomography) scan in our PET Centre. 

When you have the scan, we inject a small amount of a substance called a radioactive tracer in your arm. This shows areas of your body where cells are more active than usual. The scan produces detailed 3D pictures of inside your body, which we use to plan your treatment.

We also need to check how well your kidneys are working. We arrange for you to have a kidney test called a glomerular filtration rate (GFR) test.

Preparing for your treatment

Before each cycle of treatment, we ask you to:

• give blood samples
• have a physical examination

These tests, together with a short questionnaire about your general health, help us to decide if the treatment is suitable for you.

Your medicines

We need to know about any medicines that you take or have been given. This includes any medicines that you have bought yourself from a pharmacy or shop.

If you are also being treated with octreotide (Sandostatin LAR®) or lanreotide injections, we need to know the date of your last injection. We can then plan to give you each cycle of lutetium therapy in the days just before your injection.

If you take octreotide injections every day, we will explain when to stop these. You can eat, drink and take all other medicines as usual on the day of your treatment, unless our team gives you other advice.

Preparing to come to hospital

Please contact us in advance if you need a hoist (piece of medical equipment to help lift or move you safely), transport or a translator when you have your treatment.

If you stay in hospital overnight after your treatment, you will need an overnight bag with nightwear and toiletries.

The time that visitors can spend with you is restricted. We talk to you about this before you start your treatment.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have lutetium therapy, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

You can read more about our consent process.

During the procedure

You have your treatment in the nuclear medicine department at Guy's Hospital. The whole procedure takes about 5 hours.

What happens during the procedure

1. We put a small plastic tube called a cannula into a vein of your arm.
2. First, we give you medicine through the cannula to stop you feeling sick (nausea) or being sick (vomiting).
3. Next, we give you a drip (infusion) of amino acids through the cannula. This helps to protect your kidneys from the radioactivity.
4. We interrupt the amino acid infusion after about 1 hour and start giving you the lutetium therapy. You also have this as an infusion through the cannula. It takes 30 minutes.
5. After the lutetium infusion has finished, the infusion of amino acids starts again and continues for another 3 hours.
6. We then remove the cannula.

A member of our nuclear medicine physics team monitors the level of radiation in your body at intervals after the treatment.