Xofigo Radium-223 Therapy

Xofigo Radium-223 Dichloride therapy is used to treat prostate cancer that has spread to bone and no longer responds to hormonal therapies.  The medical term for this condition is metastatic castration-resistant prostate cancer. It is indicated for men whose prostate cancer has spread to the bone with symptoms, but not significantly to other parts of the body.  This therapy can help extend life and bring relief from bony pain.  

Xofigo is the brand name of a radiopharmaceutical, Radium 223 dichloride.  It mimics calcium and goes to areas in your bone that are growing quickly, such as around bone metastases. It gives off a strong energy which damages tumor cells.  However, this energy has a short range, which limits damage to the surrounding healthy tissue. 

If your physician thinks that you will benefit from the Radium-223 therapy, arrangements will be made for you to have a consultation with a Nuclear Medicine physician.  During this consultation, the physician will determine if you qualify to receive this treatment.  The physician will also explain the expected benefits and possible complications of this therapy and precautions to be followed.  You will be expected to commit to six separate monthly visits to the Nuclear Medicine Department to receive this treatment and will be asked to sign a consent form.  Radium-223 can cause your blood cell counts (such as red blood cells, white blood cells, and/or platelets) to go down.  In order to monitor this, you will be required to have a blood test done, about 2 days prior to each treatment cycle.  The Nuclear Medicine department will schedule all your six treatment appointments, 4 weeks apart, over the course of 6 months.  Each appointment will take about 30 - 45 min. 

When you arrive in the department for your therapy, a technologist will explain the entire procedure to you and give you the opportunity to ask any questions. The technologist will measure your weight to ensure that the correct amount of dose is administered to you.  The technologist will then set up an intravenous line in a vein in your arm and connect it to a saline bag.  While the saline is running, the technologist will calculate and verify your dose in the presence of a Nuclear Medicine physician.  This dose will be administered to you through a port in the saline line.  The Nuclear Medicine physician will be available to inquire about your wellbeing and address any concerns.   Once the IV infusion is complete, the IV line will be taken out.  You will be able to leave the department without any ill effects from the procedure.

• Bring your Health card.
• You will need to get a blood test done 2 days prior to each treatment cycle to monitor your blood cell counts before proceeding with the treatment.  No other preparation is necessary. 

The most common side effects seen in people receiving this therapy are: 

• Nausea
• Diarrhea
• Vomiting
• Injection site reactions
• Low blood cell counts 

It is very important to tell your health care provider if you have any side effects that bother you or do not go away. Blood cell count monitoring blood tests are very important.  Make sure to keep your appointments and let your doctor know if you experience symptoms such as shortness of breath, tiredness, bleeding or bruising, infection or a fever.  These may be signs of low blood cell counts.

You can have sexual relations while being treated with Xofigo Radium-223 therapy.  Because of the possible effect that radiation can have on sperm, it is necessary to always use a condom.  Female partners of childbearing age should use effective contraception during your treatment and for 6 months after this treatment is over.

There are no restrictions regarding contact with other people after receiving therapy.  

You should follow good hygiene to reduce radiation contact from spills of bodily fluids to household members and caregivers: 

• Wash hands well every time you go to the bathroom
• Flush the toilet several times after each use
• If you have accidents with respect to bodily waste, you or your caregiver should use disposable gloves to clean it up.   

People who have recently had Radium-223 therapy can trigger radiation detectors used for security purposes, for example at airports and seaports. If you are travelling during the intervals between your treatment appointments or within a month after your treatment cycles are completed, carry a Radium-223 card provided by the Nuclear Medicine Department.

Breastfeeding must be discontinued entirely. It is vital that you ensure that we are aware if you are pregnant and/or breastfeeding. 

No. This test is paid for by the healthcare system. The test costs several hundred dollars, so please notify the department at 613-761-4831 if you cannot make your appointment. 

If you cannot make your appointment, it is important that you notify the department at 613-761-4831 as soon as possible. Failure to make your appointment results in wasting of expensive materials that are ordered especially for your appointment and also reduces availability to other patients. Missed appointments may also result in delays of your treatments.