Radium-223 (Xofigo) Therapy for Prostate Cancer Bone Metastases

Radium-223, brand name Xofigo, is a radioactive medicine given by injection for prostate cancer that has spread to the bones and no longer responds to hormone-lowering treatment. Radium behaves like calcium, so it is taken up where bone is being actively rebuilt around metastases. There it emits alpha particles that travel less than a tenth of a millimetre, damaging tumour cells while largely sparing bone marrow nearby.

In the main clinical trial it lengthened survival by a median of about 3 to 4 months, delayed fractures and other skeletal complications, and eased bone pain for many men. It does not treat disease in lymph nodes or organs, it is not a cure, and PSA often does not fall even when it is working.

What Radium-223 (Xofigo) Therapy for Prostate Cancer Bone Metastases involves

Your oncologist and a nuclear medicine physician confirm suitability using a recent bone scan, CT of the chest, abdomen and pelvis, and blood counts. Each treatment is a slow intravenous injection over about a minute, with the dose calculated from your body weight, given through a cannula that is flushed before and after. There is no need for isolation, since alpha radiation does not leave the body in meaningful amounts. Blood counts are checked before every dose. A bone-protecting drug such as denosumab or zoledronic acid is normally prescribed alongside, particularly if you also take abiraterone or enzalutamide.

Who is a good candidate for Radium-223 (Xofigo) Therapy for Prostate Cancer Bone Metastases?

For a specific group of men with advanced prostate cancer.

• Castration-resistant prostate cancer with two or more bone metastases causing symptoms
• No known spread to liver, lungs or other organs
• Lymph nodes no larger than about 3 cm
• Adequate blood counts and bone marrow reserve
• Men who have had, or are not suited to, docetaxel and newer hormone agents, depending on local guidance

It is usually not the right choice if:

• Visceral metastases, where other treatments are needed
• Very low haemoglobin, neutrophils or platelets
• Combination with abiraterone plus prednisolone, which increased fractures in a trial and is not recommended
• Spinal cord compression or an impending fracture, which need urgent local treatment first
• Inflammatory bowel disease requires caution, because the drug leaves the body through the gut

Technique options

• Standard schedule: Six injections at 4-week intervals.
• Bone health agents alongside: Denosumab or zoledronic acid to reduce fracture risk.
• Lutetium-177 PSMA therapy: A different radioligand that reaches soft tissue as well as bone disease, chosen when PSMA PET shows suitable uptake.
• External beam radiotherapy: For one or a few painful sites or for a threatened spinal cord.

What happens during your treatment

Each visit lasts about an hour including blood review, though the injection itself takes a minute. You feel nothing unusual during it and go home or to your hotel straight afterwards. No anaesthetic is involved.

Preparing for your trip

The full course is six injections over about 5 to 6 months, which is the practical difficulty for a visitor: you would need six short trips, or a long stay. It is usually more sensible to seek a second opinion and, if the drug is available at home, have it there. If not, discuss a shared-care plan in which your local oncologist does the blood tests between visits.

• Tell the doctor about medication, allergies, pregnancy or breastfeeding, and any history of cold sores, keloid scars or autoimmune disease
• Avoid alcohol, aspirin and anti-inflammatory painkillers for a few days beforehand if your own doctor agrees, to reduce bruising
• Arrive without make-up on the treatment area and avoid sunbeds and strong sun for two weeks before

Recovery and results

Most men carry on with normal life. For about a week after each dose, flush the toilet twice, sit to urinate, wash hands well and handle soiled clothing separately, as traces are excreted mainly in the stool. Use condoms and avoid fathering a child during treatment and for 6 months afterwards. Some men notice a brief flare of bone pain in the first week.

• Back to everyday activity: None for most
• When results show: Pain relief, if it occurs, within 2 to 4 weeks
• How long they last: Course complete after about 6 months

Safety, risks and revision policy

Side effects are generally milder than chemotherapy but blood counts need watching.

• Diarrhoea, nausea or vomiting
• Low platelets, white cells or haemoglobin, occasionally needing transfusion or delay
• Temporary increase in bone pain after a dose
• Swelling of the legs
• Fractures, particularly without a bone-protecting agent
• Cancer progression outside bone during the course
• A theoretical small long-term risk of second cancers

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Radium-223 (Xofigo) Therapy for Prostate Cancer Bone Metastases in Türkiye

Clinic-Y does not publish a single price for Radium-223 (Xofigo) Therapy for Prostate Cancer Bone Metastases, because the honest figure depends on your case. What moves it:

• The drug itself, priced per injection
• Number of doses completed out of six
• Bone scans, CT and blood monitoring
• Bone-protecting medication
• Repeated travel and accommodation

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions