Safety of radiopharmaceuticals

Is radiation safe for me to receive?

All radiopharmaceuticals licensed/approved for diagnosis and treatment have been through a rigorous review process. This means that their benefits have been found to outweigh their associated toxicity.

There are no known long-term effects from diagnostic radiopharmaceuticals, which have been in use for over 70 years. Adverse events happen 1.63 times per 100,000 applications of a radiopharmaceutical. An adverse event is defined as experiencing an unintended consequence of a medication. In the case of radiopharmaceuticals, 93.3% of these adverse events are classified as ‘minor’, and they mainly involve skin reactions and a drop in blood pressure.

However, everyone views risk differently – if you have any questions, speak with a doctor about your options.

How much radiation would I be exposed to if I received radiopharmaceuticals?

The amount of radiation absorbed into the body is called the effective dose, and it is measured in sieverts (Sv). It is calculated based on the biological effect of radiation on the body and the probability of developing cancer due to radiation exposure. An effective dose of 1,000mSv results in a 5% excess chance of developing fatal cancer.

A PET scan is one of the most common uses of radiopharmaceuticals. The average effective absorbed dose after a scan has been measured as being between 8 and 27mSv. The recommended maximum yearly radiation dose limit is 50mSv. A PET scan using radiopharmaceuticals is half of this annual maximum at most. It is therefore classed as being low risk, and the benefits are seen to outweigh the risks.

If you have any concerns about exposure to radiation and would like more information about the risks and benefits, speak with a primary care physician or a nuclear medicine or radiation specialist.

Effectiveness of radiopharmaceuticals

Can radiopharmaceuticals cure my cancer?

Radiopharmaceuticals alone cannot cure cancer, but when used as a treatment, they can help shrink tumours and increase the time it takes for the cancer to progress. In the types of cancer that radiopharmaceuticals are approved for, these agents can improve quality of life and extend life expectancy.

Treatment with radiopharmaceuticals can extend progression-free survival for people with neuroendocrine neoplasms (NENs) and shrink tumours in bone metastases from prostate cancer and in metastatic castration-resistant prostate cancer (mCRPC).

Treatment with radiopharmaceuticals has also been found to decrease rates of recurrence and mortality over a 10-year period in people with thyroid cancer.

Availability of radiopharmaceuticals

How do I know whether I am eligible for treatment using radiopharmaceuticals?

Treatment with radiopharmaceuticals has been approved for:

  • thyroid cancer
  • neuroendocrine tumours
  • metastasised prostate cancer
  • certain types of lymphoma
  • phaeochromocytoma

If you have one of these cancers, you may be eligible for treatment using radiopharmaceuticals. If you think you may be eligible, talk with a healthcare professional about it.

When will radiopharmaceuticals be available for my type of cancer?

Clinical trials investigating the use of radiopharmaceuticals to treat other types of cancer are ongoing. Radiopharmaceuticals are being investigated for the treatment of melanoma, lung cancer, colorectal cancer, leukaemia, head and neck cancers, neuroblastomas, breast cancer and ovarian cancer. As researchers learn more about radiopharmaceuticals, additional cancer types may be trialled for suitability.

You can keep up to date with radiopharmaceutical clinical trials at the Oncidium foundation’s web page, and you can learn more about individual studies via the clinical trials database.

You can also ask your oncologist or primary care doctor whether they are aware of any radiopharmaceutical clinical trials for your type of cancer.

Where can I receive radiopharmaceuticals?

Radiopharmaceuticals are offered in both outpatient and inpatient clinics. The way the treatment is administered will be specific to the country or hospital providing it.

The Oncidium foundation has created a map of centres across the world that provide radiopharmaceutical diagnostics and therapies. It gives details about each centre, including the types of cancer that are treated, what imaging technologies are used, whether clinical trials are being conducted there, the capacity of the service (how many people they can care for) and the conditions of treatment.

Will I have to travel to receive radiopharmaceuticals?

If there is no suitable centre near you or even in your country, it may be possible to travel for treatment. Talk with a healthcare professional to learn about your access options for radiopharmaceuticals.

Advocacy for radiopharmaceuticals

What larger professional and clinical organisations are carrying out radiopharmaceuticals advocacy activities?

The Stakeholder Political Alliance for Radioligand Cancer Therapies (SPARC-Europe) is a new policy initiative that aims to build a comprehensive policy framework for radioligand therapies that use radiopharmaceuticals. Its main objective is to work with policymakers to accommodate innovation and improve outcomes for people with cancer.

The European Association of Nuclear Medicine (EANM) is the umbrella organisation that represents the nuclear medicine sector across Europe. It engages in advocacy work in the form of outreach and liaison with policymakers, the publication of papers on nuclear medicine, and partnerships and cooperation with other scientific societies and institutions. It also contributes to EU documents such as Europe’s Beating Cancer Plan. You can contact EANM if you’re interested in getting involved with advocacy activities.

The Society of Nuclear Medicine & Molecular Imaging (SNMMI) is a US-based professional organisation that promotes the practical application of nuclear medicine and molecular imaging. It engages in a wide range of advocacy activities and is active in legislative change; it has drafted a bipartisan bill that, if approved, would facilitate the provision of radiopharmaceutical diagnostics. The society has also developed a Congressional Advocacy Toolkit that empowers US-based advocates to engage policymakers around the implementation of nuclear medicine.