Quadramet® (Samarium Sm-153 Lexidronam Injection) A Question and Answer Guide for Patients
Why would someone with cancer of the prostate, breast, or lung have pain in the bones?
Certain types of cancer can spread to other parts of the body. Cancers of the prostate, breast, lung, and other organs often spread to the bones. This causes pain that can be very hard to relieve.
What can I do if my medicine doesn’t help with this kind of pain?
If you have reached a point where your pain medicine doesn’t relieve your pain, it may be time to adjust your dosage or to change the kind of medicine you receive.
What other pain relief options are there?
Pain relief is an important part of your cancer treatment. You may receive more than one type of treatment for your pain. Some patients with cancer receive localized radiation therapy from a radiation treatment machine along with medicines for pain. Quadramet® is another good option for many patients because it has few side effects. It can relieve pain in many of the bones throughout your body.
What is Quadramet®?
Quadramet® is a radiopharmaceutical—a drug that has a radioactive ingredient. These types of drugs are used in both the diagnosis and treatment of cancer.
How does Quadramet® work?
Quadramet® contains a radioactive ingredient that is designed to target spots where cancer cells have traveled to the bones. This means that healthy bone and other normal tissues have very little contact with the active ingredient. Because Quadramet® is carried throughout your body in the blood, it can reach and relieve pain in your bones in many sites.
How is Quadramet® given?
Quadramet® therapy is easy and convenient. A small needle (IV) will be placed in your arm or hand. Fluid will be given through the IV. Quadramet® is given through the IV over one to three minutes. Expect to be in the clinic one to two hours. Then you can go about your normal routine.
When will I start to notice pain relief?
Patients may notice the start of pain relief as soon as one week after treatment. This means that their bones have absorbed the drug and it is working on the cancer cells. Other patients may take longer to respond. A few patients may not notice any relief.
Patients who respond to this treatment find that pain relief keeps improving for three to four weeks after the treatment. Many patients find that they can reduce the amount of other medicines they take for pain. Relief lasts about 16 weeks (four months).
Some patients may notice a slight increase in bone pain shortly after they receive Quadramet®. This often occurs within 72 hours. This increase most often goes away. It can be relieved by over-the-counter products like Advil®, Tylenol®, or Aleve®. Your doctor may also prescribe stronger pain relievers if needed.
Are there any side effects?
The main side effect of Quadramet® treatment is a short-term decrease in blood counts. In most cases, patients do not notice any symptoms. In clinical trials of Quadramet®, these counts tended to return to the same level as before treatment within about eight weeks. Your treatment team should give you regular blood tests to make sure this recovery is taking place. If you notice any other side effects that you think may be related to your Quadramet® therapy, call the Radiotherapy Clinic right away at (608) 263-8500.
What if the pain returns?
If your pain does start to come back, do not delay in telling your doctor. Many patients get pain relief with Quadramet® when it is given again.
Are there any special safety measures I should take?
There are some basic steps you should take for a day or so after getting Quadramet® to protect yourself and others.
- Drink at least two cups (one pint) of water, juice, or other liquid just before you receive Quadramet®. This will fill your bladder and help to protect it from exposure to the radiation.
- Remember that for about 12 hours, radioactivity will be present in your urine. During the first few hours after your treatment, drink extra fluids and urinate as often as you can. If you are a man, use a toilet, if possible, rather than a urinal.
- Flush the toilet twice when you are finished. Clean up any spilled urine right away. Wash your hands well.
- If any urine or blood gets on your clothing, wash the clothing right away.
Other safety measures
- Before you receive Quadramet®, tell your doctor if you are pregnant, trying to become pregnant, or nursing. If you are pregnant or nursing now, you should not use Quadramet®. Ask your doctor about other pain treatment options. You should use an effective method of birth control until your treatment with Quadramet® is complete.
- You should also tell your doctor if you have had an allergic reaction to a bone scan drug or any other phosphonate drug.
Will I be able to be close to other people? What about sexual relations?
You do not have to change the way you interact with your friends, family members, or caregivers after your treatment. Even though it’s possible to expose your sex partner to some radiation, the amount is quite small. It is about the same as having an x-ray. We suggest that you refrain from sexual contact for about 12 hours. That is plenty of time for the radioactive dose to be cleared from your system.
Should I tell anyone that I’ve received Quadramet®?
For about eight weeks, any health practitioner you see should be aware that you have received Quadramet® therapy. This includes your dentist, doctor, nurse, and pharmacist. If they have any questions, they should call your doctor at (608) 263-8500 for information, or call Berlex Professional Services at 1-800-888-4112. No one else needs to know unless you choose to tell them.
Will receiving Quadramet® affect my daily routine?
Any radiation that has not been absorbed by bone is cleared from your body within about 12 hours. There is no reason you should limit your activities. You may exercise, drive your car, and enjoy being with your friends and family. Feel free to eat and drink what you normally do, unless your doctor tells you something else.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 01/22/2008
Copyright © 01/22/2008 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6624
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