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Theranostics Therapy: A New Horizon

Vials of medications.

In a groundbreaking stride with personalized health care for Veterans, the Lebanon VAMC is leading the VA in a new type of treatment for Veterans suffering from metastatic prostate cancers and neuroendocrine tumors.

This new treatment is called Theranostics. It is a specialized field of medical practice within nuclear medicine that uses a two-pronged approach to diagnose and treat cancer. 

Theranostics utilizes isotopes such as lutetium 177 to specifically attack the cancer cells by destroying the DNA of the cancer cells, while leaving the host cells unharmed. This specialized approach allows physicians to directly attack the cancers affecting the Veteran, without compromising the whole system.

“Chemotherapy is attack on the whole system, in an attempt to kill the cancer cells,” said Dr. Adwoa Essel, VA Nuclear Medicine Physician, “whereas theranostic medicine allows us to directly get at the cancer cells with little to no effect on the whole system.” In other words, where chemotherapy is akin to a full military assault, theranostic treatments act more as a special forces unit for specific missions.

The process begins for patients by scheduling a prostate specific membrane antigen (PSMA) PET scan to accurately map the locations of cancer cells within the human body. During the PSMA PET scan, a patient is provided isotopes which travel through the body and seek out specific receptors, since PSMA antigens are over expressed by these cells. 

After mapping the locations of these cells throughout the body, the patient is then provided isotopes of lutetium 177. This slightly larger molecule will actively seek out the mapped locations through the PSMA antigens that are over expressed. This allows the nuclear medicine therapy to identify and destroy the DNA of each of those cells. Through the use of this targeted medical procedure, little side effects are felt by the patient. 

“I was scared, you know, who wouldn’t be?” said Bruce Bomberger, a Vietnam Era Veteran and theranostic therapy recipient, “I was scared to lose my hair and appetite. But that never happened! I never had any of those side effects that you always hear about. I am so thankful.” 

Despite the advances made with cancer treatments, theranostic treatments do not cure cancer, but they do extend the length and quality of life for those who may need other treatment options. “No, it didn’t cure my cancer,” said Mr. Bomberger, “but it gave me a lot more time with my family. For that I couldn’t be happier, because there is no other reason to be here other than family. The VA really helped me here. I recommend this treatment to anyone who needs it.”

Lebanon VAMC is the first VA medical center in the country to be approved through a new rigorous process to offer these services as part of their cancer care. Currently the FDA has approved the use of Lutetium 177 theranostic medicine as a 3rd line treatment for these types of cancers. As such, most patients will have to utilize hormone and chemotherapies prior to being permitted to receive treatment with theranostic procedures. “In the private sector the necessity to go through these steps for treatments can create a myriad of paperwork and often times be confusing for patients,” said Dr. Essel, “by comparison, here in the VA, we are able to identify patients who would be ideal candidates for this procedure and move them through our system with much less stress for the patient.”

In an era marked by unprecedented advances in medical science and technology, theranostic medicine stands as a beacon of hope for Veterans seeking personalized, effective, and compassionate care. By harnessing the power of precision medicine, this innovative approach has the potential to vastly improve  Veterans’ cancer treatment, offering new pathways to healing, recovery, and resilience.