What is radium 223?

This page tells you about a new treatment called radium 223. There is information about

What radium 223 is
How you have radium 223
Radium 223 in the UK
Research into radium 223

Radium 223 is a new type of internal radiotherapy treatment. Researchers are looking at using it for cancers that have spread to the bone. It is also called Alpharadin.

Radium is very similar to calcium. Like calcium it is taken up by active bone cells. This makes it a good way of targeting bone cancer cells. Cancer cells are more active than bone cells and so more likely to pick up the radium 223.

Radium 223 treatment uses a type of radiation called alpha particles to kill cancer cells. Your doctor injects the radium 223 into your blood and it circulates to your bones. The cancer cells in the bone take it up. The radiation only travels a short distance, between 2 and 10 cells deep. This is much less than a millimetre. So it means that the cancer cells receive a high dose of radiation. But healthy cells receive only a low dose or no radiation. So this treatment causes fewer side effects than some other types of radiotherapy.

Most of the research so far has looked into radium 223 as a treatment for men with prostate cancer that has spread to the bone. Trials are also looking into it for breast cancers that have spread to the bone.

You have radium 223 as an injection into a vein. Usually this is through a thin short tube (a cannula) put into a vein in your arm each time you have treatment.

The researchers are still working out how many treatments are best. In the most recent research for prostate cancer that had spread to the bone, men had an injection of radium 223 once every 4 weeks. They had 6 injections in total. We need more research to find out if the treatment continues working if it is given for a longer time. And we also need to find out whether the side effects increase with longer treatment.

Radium 223 is not available as a standard treatment in the UK at the moment. You can only have it as part of a clinical trial.

Early phase trials showed that radium 223 could help men with prostate cancer that had spread to the bones when hormone treatment was no longer working. It also found that the side effects were mild.

A large international phase 3 trial called ALSYMPCA reported in 2012. The aim of the trial was to find out whether adding radium 223 to best standard care led to men living longer and was safe. The trial was for men whose prostate cancer was no longer responding to hormone therapy. The results showed that on average men who had radium 223 and the best standard treatment lived about 3½ months longer than men who had only best standard treatment. The side effects included diarrhoea and sickness but were generally mild. Rarely, radium 223 also caused a temporary drop in blood cells leading to an increased risk of infection. And some people bruised more easily because of low platelets.

These trial results are very positive. But as this treatment is still in research, it is not yet available on the NHS.

There is more research looking into giving radium 223 with the chemotherapy drug docetaxel for men with advanced prostate cancer. And trials are also using it for breast cancer that has spread to the bone. You can find out about radium 223 trials on the clinical trials database. Type 'radium' into the free text search box.