Xofigo® Therapy

What is Xofigo®?

Xofigo is a radioactive liquid given as an injection into a vein in your arm. Xofigo® contains Radium-223, a radioactive element chemically similar to calcium, which is absorbed into sites of bone cancer. The Radium-223 emits very short-range alpha particles, delivering a dose of radiation to cancer cells in the bone without affecting normal bone cells.

Xofigo (zo-FEEG-oh) is a treatment for patients with prostate cancer that has spread to the bones. It is used when other treatment options for this condition become limited. It can help to relieve bone pain, slow progressive disease and reduce complications such as bone fractures. This leaflet explains what is involved in Xofigo® therapy and the benefits and side effects of the treatment.

 

What are the benefits of Xofigo® therapy?

Xofigo has proven potential to extend life expectancy in this type of cancer. Xofigo can relieve bone pain and reduce the risk of bone fractures.

 

What are possible side effects from Xofigo® therapy?

As with many types of cancer treatment, there are some possible side effects with Xofigo® therapy. The most common of these are nausea, diahorrea, vomiting and swollen arms and legs. These occur in about 1 in 10 patients. Xofigo® can also cause low blood cell counts, which is why you will have a blood test before each injection. You may also experience a temporary increase in bone pain in the few days after each injection.

 

What is involved?

A course of Xofigo therapy usually consists of six injections given at 4 – Week intervals. The Nuclear Medicine Department will arrange your injections and inform you of the dates you will need to attend. You will also see your Oncology Consultant regularly over the course of therapy to confirm that you are well enough to receive the treatment.

Therapy pre-assessment

Approximately one week before your first treatment, you will need to attend the Nuclear Medicine Department for the following:

  • Consultation with the Nuclear Medicine Physician
  • Discussion about radiation risks and precautions with a Medical Physicist
  • A blood test
  • A bone scan, if the Nuclear Medicine Physician thinks it is necessary

The Nuclear Medicine Department will arrange these appointments. You can expect to be in the Department for approximately 1 hour for your pre-assessment. If a bone scan is required, you should allow a total of 4-5 hours for your appointment. Your appointment letter will state how long you are likely to be with us.

 

Xofigo therapy procedure

It is important that you receive all six treatments. We tailor each treatment specifically for your requirements, and we order the Xofigo especially for you. The Xofigo cannot be used for another patient and if you do not receive it promptly, it will be wasted. It is therefore important that you inform us if there are likely to be any problems with your appointment dates.

About one week before each treatment, you will need to have a further blood test. This is because Xofigo can affect the cells in your blood. The bloods will usually be taken during your appointment with your Oncologist. If your blood count does look abnormal, we may need to delay your treatment. It may be possible to take steps to improve your blood count, allowing you to continue Xofigo therapy. This will be discussed with your Oncology Consultant as necessary. Please allow approximately one hour for each treatment appointment. The injection of Xofigo is very quick; however, the preparation takes time to ensure that the correct amount of radiation is given.

When you attend the Nuclear Medicine department for the treatment, we will initially check your height and weight. You will be taken into one of our clinical rooms, and a small needle will be inserted into a vein in your arm. The positioning of the needle will be checked using a saline drip. Once we are satisfied with this, the Xofigo is administered slowly through the needle. To make sure that all of the Xofigo is given, this is followed by a saline flush. You should not experience any pain during this process.

When this is finished, the needle will be removed from your arm. You will be given a “yellow card” which explains the radiation protection precautions you will need to follow, and how long for. After this, you may go home. There are no restrictions on travelling by public transport, and you will be able to drive yourself home.

 

What are the benefits of Xofigo therapy?

Xofigo has proven potential to extend life expectancy in this type of cancer. Xofigo can relieve bone pain and reduce the risk of bone fractures.

 

What are possible side effects from Xofigo therapy?

As with many types of cancer treatment, there are some possible side effects with Xofigo therapy. The most common of these are nausea, diahorrea, vomiting and swollen arms and legs. These occur in about 1 in 10 patients. Xofigo can also cause low blood cell counts, which is why you will have a blood test before each injection. You may also experience a temporary increase in bone pain in the few days after each injection.

 

Are there any risks from the radiation?

After each injection, you will be asked to follow some simple safety precautions. This is because your body fluids will be slightly radioactive after the injection. These precautions will last for seven days and will include observing good hygiene after using the toilet and washing any clothes contaminated with urine separately. If you are sexually active, you will also be asked to use condoms for six months after the end of your course of therapy.

Your “yellow card” will contain information to remind you of these precautions as well as our contact details so that if you have any concerns, you will be able to speak directly to one of the Medical Physics team.

 

Are there any alternatives to Xofigo therapy?

Your Oncologist has referred you for Xofigo therapy because they think it is the best option for you. However, there are alternatives available, called Strontium or Samarium therapies. These are Nuclear Medicine therapies similar to Xofigo  therapy.

For these therapies a single radioactive injection is given, instead of six injections one month apart. These therapies have also been shown to reduce bone pain, but have not been shown to improve life expectancy. If you would like to know more about these therapies, you should discuss them with your Oncologist.

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