Learning About Radium-223 (Xofigo) Therapy

Radium-223 (Xofigo) is a type of targeted radiation treatment. It's a medicine that contains a radioactive substance. It’s used to treat advanced prostate cancer that has spread to the bones. It does not treat prostate cancer that has spread to organs such as the liver or lungs.

Radium-223 is given by injection into a vein. It travels through the bloodstream and collects in areas of bone where cancer is growing. In those places, it damages nearby cancer cells but limits radiation to surrounding healthy tissue.

Your doctor may recommend radium-223 to:

• Help slow the growth of prostate cancer in your bones.
• Help reduce bone pain caused by cancer.
• Reduce your risk of bone damage due to cancer.
• Help you live longer.

Radium-223 is one part of an overall treatment plan. Your doctor may recommend it along with other treatments for prostate cancer.

Radium-223 may be an option if you:

• Have prostate cancer that has spread to the bones.
• Have prostate cancer that no longer responds to hormone therapy (castration-resistant prostate cancer).
• Have symptoms from bone metastases, such as bone pain.
• Don't have prostate cancer cells in organs such as the liver or lungs.

Your doctor will decide if radium-223 is right for you based on your health and treatment history.

Radium-223 is given as an injection into a vein. Before each treatment, you will have blood tests. These are to make sure that your blood cell counts are high enough to safely receive the medicine.

Treatment is usually given once every 4 weeks, up to 6 treatments.

The injection takes only a few minutes. Most people receive outpatient treatment. This means that you'll go home the same day.

Like all cancer treatments, radium-223 can cause side effects. These may include:

• Tiredness.
• Nausea.
• Diarrhea.
• Vomiting.
• Swelling of the legs, ankles, or feet.
• Low counts of red blood cells (anemia).
• Low counts of white blood cells, which can increase the risk of infection.
• Low counts of platelets, which can increase the risk of bleeding and bruising.

Some people may also have bone fractures, especially if their bones are already weakened. Your doctor may prescribe a medicine to help strengthen your bones during treatment.

Report any side effects or concerns to your doctor.

Most people can return to normal activities later the same day or the next day.

Small amounts of radium-223 leave your body through stool and urine for about a week after each treatment. Your healthcare team will give you instructions to help protect others from radiation. These will include steps for safely using the toilet and washing clothing and bedding. You may be told to take these steps for the next 7 days:

• Sit down to urinate.
• Close the toilet lid before flushing.
• Flush the toilet twice after each use.
• Wash your hands well after using the toilet.
• Wear disposable gloves when you clean up any spilled urine, stool, or vomit.
• Wash soiled clothing or bed linens separately from other items.
• Carefully bag up urine pads or diapers, and put them in the trash.

Radium-223 can affect sperm and harm a developing baby (fetus). Wear a condom if you are sexually active during treatment and for 6 months afterward. Any partners who could get pregnant should also use effective birth control.

Go to all follow-up appointments. Your doctor will monitor your blood cell counts and check to see how you are responding to treatment.