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Patient Education — What to Expect
What to Expect as a Theranostic Patient
From your first scan to going home — a step-by-step guide.
Theranostics finds the cancer with a scan, then treats it with radiation delivered straight to the cancer cells. Here’s who you’ll meet, what happens on treatment day, and how to stay safe at home.
Start here
Image first, then treat
Theranostic treatments combine a scan and a treatment that both aim at the same target on your cancer. They use radiopharmaceuticals — medicines that carry radiation directly to cancer cells while sparing as much healthy tissue as possible.
Theranostics has been used mostly for prostate cancer and neuroendocrine tumors, and is now being studied in clinical trials for many other cancer types.
See it
Diagnostic PET scanThe light bulbs
A small dose of a tracer lights up wherever the target is. This shows where the cancer is — and whether it carries enough target for the treatment to work.
Treat it
Radioligand therapy (RLT)The bombs
The same kind of carrier now brings a stronger radioactive “cargo” to those very same spots, delivering radiation right where the scan lit up.
Remember
This page is a general guide. It is not a substitute for advice from your own care team. Always discuss your specific treatment plan, risks, benefits and instructions with your theranostics providers.
A team of specialists works together on your care
01
Your primary oncologist
Your main cancer doctor, who decides when a PET scan or theranostic treatment is appropriate and fits it into the right order with your other treatment and imaging options. They start the process.
02
Authorized User (AU)
A specially trained and licensed physician — usually a nuclear medicine physician or radiation oncologist — who oversees your radiopharmaceutical treatment.
03
Nuclear medicine technologists
Licensed technologists who prepare and administer the radiopharmaceutical, and who perform your scans.
What your team will explain
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Which radiopharmaceutical you’re getting and why it was chosen for your cancer.
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How it finds your cancer — the target it’s designed to seek out.
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What benefits to expect and how you’ll know whether it’s working.
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Possible side effects such as dry mouth, tiredness, nausea or changes in blood counts — and how to manage them.
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Safety precautions to protect your family and others after each treatment.
Step by step
Your treatment journey
Every center and every treatment is a little different, but most patients follow a path like this one.
- 1
Consultation
You meet the theranostics team, review your history and scans, and talk through whether this treatment is a good fit.
- 2
Diagnostic PET scan
A PET/CT scan checks that your cancer carries the target. If the spots light up brightly, the treatment has somewhere to go.
- 3
Blood tests and planning
Labs check your blood counts and kidney function to make sure treatment is safe. Your team then schedules your doses.
- 4
Treatment day
The radiopharmaceutical is usually given as a slow injection through an IV. Afterward you rest for a while in a protected room while your team checks on you.
- 5
Home, then repeat
For most patients receiving the treatments available today, it is very safe to go home the same day with written safety instructions. Treatment is usually given in several doses, weeks apart, with blood tests and check-ins between them.
How many doses? It depends on the treatment. For example, Pluvicto for prostate cancer is given up to 6 times, about every 6 weeks, and Lutathera for neuroendocrine tumors is given 4 times, about every 8 weeks. Clinical trials may follow different schedules.
How you may feel
Common side effects
Because the radiation goes mostly to the cancer, many patients find theranostics easier than they expected. Most side effects are mild to moderate.
Better yet, theranostic side effects are usually very predictable. They come from two simple things: where else the target is found in the body, and where the isotope travels on its way through and out of the body. Your team knows both ahead of time — so they know what to watch for, and how to help.
The target
Where else it livesHealthy tissue with the same marker
Some targets also sit on a few normal tissues. PSMA, for example, is also found on the salivary and tear glands — which is why dry mouth and dry eyes can happen.
The isotope
Where it travelsThe path through your body
As the treatment circulates, it passes the bone marrow, which makes blood cells. Then it leaves mainly through the kidneys and bladder. That’s why blood counts and kidney function are checked regularly.
What you might notice
Mouth
Dry mouth
Some targets, like PSMA, also sit on the salivary glands. Sipping water, sugar-free gum and good mouth care can help.
Energy
Tiredness
Feeling tired is common for a few days to weeks after each dose. Gentle activity and rest both help.
Stomach
Nausea
Usually mild and short-lived. Anti-nausea medicine can be given before or after treatment.
Blood
Blood counts
The bone marrow gets some radiation as the treatment circulates, so counts can dip. That’s why you’ll have regular blood tests between doses.
Call your team
Contact your care team right away if you have a fever, unusual bleeding or bruising, nausea or vomiting that keeps you from drinking fluids, or any symptom that worries you.
Your team would always rather hear from you early. There’s no such thing as a silly question.
Keeping your family and others safe
After treatment, a small amount of radiation stays in your body for a few days and leaves mainly through your urine. Before you go home, your team checks that you meet radiation-safety release criteria, which protect your family, caregivers and the public.
Most patients go home the same day, especially after common beta treatments. Release criteria are the safety rules that decide when you can leave — and they can vary a great deal from center to center and from country to country. They depend on:
01
The isotope
Beta and alpha treatments have different rules.
02
The dose
How much radioactivity you received.
03
Your body
How quickly your body clears the treatment.
04
Where you’re treated
Each country, state and treatment center sets its own rules.
Rules vary
Your center’s release criteria may be different from what a friend, an online group, or another hospital describes — even for the same treatment. Some countries require a hospital stay for treatments that are given as an outpatient elsewhere.
The examples below are typical, not universal. Your own team’s rules are the ones to follow.
Typical precautions at home
After a beta treatment
Example: Lu-177 (lutetium-177), such as Pluvicto®
For roughly the first few days, you may be asked to avoid being closer than about 3 feet to others for more than 30 minutes at a time, and to sleep in a separate bed.
Take extra care around children and pregnant women, often for longer.
After an alpha treatment
Example: Ac-225 (actinium-225), currently in clinical trials
Alpha radiation travels only a few cell-widths and can’t pass through your skin, so close contact is usually fine right away.
You may still be asked to follow simple bathroom and hygiene steps for a short time.
Simple habits for the first few days
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Drink plenty of fluids and use the bathroom often — this helps flush the leftover radiation out.
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Sit to urinate, flush twice, and wash your hands well afterward.
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Wash your laundry and dishes separately if your team recommends it.
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Carry your treatment card or letter when traveling. Airport and border radiation detectors can pick up small amounts for weeks.
You’ll get written instructions before you leave. They are tailored to your treatment, dose and home situation — always follow your own team’s instructions over any general guide.
Be prepared
Questions to ask your care team
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Which treatment am I getting, and what does it target? Is it beta or alpha? Approved or part of a trial?
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How many doses, and how far apart? What tests happen between them?
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How long will I be at the center on treatment day? Should someone drive me?
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Which side effects should I watch for, and who do I call after hours?
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What precautions do I need at home, especially around children, pets or a pregnant partner — and for how long?
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How will we know if it’s working? Which scans and blood tests will we follow?
Theranostics offers promising, targeted options for many patients. Open communication with your care team is the key to feeling prepared — if you have a concern, ask. They are there to guide you every step of the way.
Keep going
Where to next
Educational content, not medical advice. Always discuss your specific treatment plan, risks, benefits, and instructions with your Theranostics care team.
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