Theranostics

Theranostics is a precision medicine approach that combines advanced imaging and targeted therapy. It uses radioligand therapy, which delivers a small amount of radioactive medicine directly to cancer cells by attaching to a molecular target found on those cells. This allows doctors to both see and treat the cancer with one process.

Unlike traditional cancer treatments, including surgery, standard radiation, or chemotherapy, theranostics is designed to target cancer cells while limiting exposure to healthy tissue. 

Theranostics is a targeted treatment that can help people with certain types of cancer. First, a special scan checks whether cancer cells have a specific target. If they do, treatment can be delivered directly to those cells while helping protect healthy tissue.

Theranostics is most often used for:

Prostate Cancer

PSMA-targeted theranostics is used for some people with advanced prostate cancer. A PSMA PET scan helps determine if this treatment may be an option.

It may help people with:

• Prostate cancer that has spread to other parts of the body
• Metastatic castration-resistant prostate cancer (mCRPC)
• PSMA-positive prostate cancer found on PET imaging
• Cancer that has continued to grow after hormone therapy, chemotherapy, or other treatments

Neuroendocrine Tumors (NETs)

Theranostics can also treat some neuroendocrine tumors, which are rare cancers that can develop in the digestive system, pancreas, lungs and other parts of the body.

It may help people with:

• Small bowel neuroendocrine tumors
• Pancreatic neuroendocrine tumors
• Gastrointestinal neuroendocrine tumors
• Neuroendocrine tumors that have spread or cannot be removed with surgery

Other Cancers Being Studied

Researchers are studying theranostics for additional cancers, including:

• Thyroid cancer
• Certain brain tumors
• Breast cancer
• Lung cancer
• Other cancers with specific molecular targets.

Not every cancer is a match for theranostics. Your care team will use advanced imaging to determine whether the treatment is right for you and discuss all available options.

Theranostics is not appropriate for every patient or every type of cancer. Before treatment, specialized imaging is used to confirm that the cancer expresses the molecular target needed for therapy. If the target is present, theranostics may be used alone, between other treatments, or alongside surgery, systemic therapy, or radiation as part of a personalized care plan.

Preparation

Eligibility review: We collect your records and prior treatments, check blood counts and kidney function and discuss medicines you take. We also look at overall health and goals.

Imaging: A PET scan uses a tiny amount of radiotracer to show where specific cancer cells appear. If your scan is positive for the particular radioligand, you may be a candidate for treatment.

Team consultation: You’ll meet with specialists in nuclear medicine, medical oncology, radiation oncology and sometimes urology. Together, we design a plan tailored to you.

Scheduling and coverage: Our patient navigators help with insurance authorization, appointments and preparation tips. You’ll receive simple safety guidance for home and a number to call with questions.

During the Procedure

When you arrive:
You'll receive treatment in a specialized outpatient setting designed for theranostics and nuclear medicine procedures. Your care team will review your treatment plan, perform any needed safety checks and place an IV before treatment begins.

During treatment:
The theranostic medicine is given through an IV. Once in your bloodstream, it travels through the body and attaches to specific targets on cancer cells. This allows the treatment to deliver radiation directly to those cells while limiting exposure to healthy tissue.

What it feels like:
Most people feel comfortable during treatment and can relax, read, listen to music, or use their phone. Some patients feel tired, warm, or mildly nauseated. Let your care team know if you feel uncomfortable at any time so we can help.

Safety and monitoring:
Your care team will monitor you throughout your visit. Because theranostics uses a small amount of radioactive medicine, you'll receive simple safety instructions to follow at home. These may include drinking extra fluids and taking a few temporary precautions around others.

Before you go home:
Most patients return home the same day. Depending on your treatment plan, you may have imaging before or after therapy to help your team monitor how the treatment is working and plan your follow-up care.

Recovery and Follow-Up

Right after treatment: Most people go home the same day. Expect mild tiredness. Drink plenty of fluids to help your body clear the medicine. We’ll give you short‑term safety steps and a number to call 24/7.

Side effects and self‑care: Common effects include fatigue, nausea, dry mouth and lowered appetite. These are usually manageable. Rest, small frequent meals and good hydration can help. Call your provider right away for persistent vomiting, fever, chest pain, shortness of breath, or bleeding.

Monitoring plan: Follow‑up includes regular clinic visits, blood tests and periodic scans to see how you’re doing. Visits are scheduled at set intervals during treatment cycles and then less often afterward—your team will explain the exact timing for you. We track symptoms, lab trends and imaging to tailor next steps.

Getting back to life: Most daily activities can continue, with a few short‑term precautions that we review together. Many patients notice energy improving over days to weeks.

Support for you and your family: The University of Cincinnati Cancer Center offers survivorship services, nutrition counseling, rehabilitation and integrative medicine. Caregivers can access resources and education, too. Your patient navigator stays with you from treatment through follow‑up to make appointments and answer questions.

Potential benefits

• Precision targeting: Treatment seeks out cells seen on imaging, aiming radiation where it’s needed most.
• Disease control & symptom relief: May help slow or shrink cancer and ease pain or other symptoms, supporting daily life.
• Protects healthy tissue: Because it targets cancer cells, there’s typically less exposure to surrounding organs.
• Outpatient care: Most people go home the same day with only short‑term precautions.

Possible risks and side effects

• Common: fatigue, nausea, dry mouth, decreased appetite, constipation.
• Blood counts: temporary drops in red cells, white cells, or platelets; we check labs before each cycle and manage as needed.
• Less common: changes in kidney or liver tests, infection, bleeding, or allergic reactions.
• Radiation safety: a small amount of radiation remains in your body for a short time; we provide clear home instructions to protect family members.

What influences your risk

• Prior treatments, overall health, tumor burden, kidney function and timing between cycles.

How UC Health keeps you safe

• Care follows strict national guidelines, with dose planning, on‑site radiation safety, supportive medicines (such as anti‑nausea) and 24/7 access to our team. We’ll review benefits, risks and alternatives together so the plan fits your goals.

Theranostics is one option within a larger cancer treatment plan. Depending on your type of cancer, overall health and treatment goals, your care team may also discuss:

• Surgery: Removing all or part of a tumor when it can be safely treated with an operation.
• Radiation therapy: Using high-energy radiation from outside the body to destroy cancer cells or help relieve symptoms.
• Chemotherapy: Medicines that travel through the bloodstream to kill cancer cells throughout the body.
• Targeted therapy: Treatments that focus on specific genes, proteins, or other features that help cancer grow.
• Immunotherapy: Treatments that help the body's immune system find and attack cancer cells.
• Clinical trials: Research studies that give eligible patients access to promising new treatments.

When is theranostics preferred? Theranostics may be recommended when imaging shows that a cancer has the specific target needed for treatment. It can be especially helpful when cancer has spread, cannot be removed with surgery, or has stopped responding to other therapies.

When might another treatment be a better choice? If imaging does not show the right target, or if surgery, radiation therapy, chemotherapy, or another treatment is more likely to help achieve your goals, your care team may recommend a different approach. Your treatment plan will be personalized to your diagnosis and needs.

At the University of Cincinnati Cancer Center, we provide advanced theranostics care for patients with prostate cancer, neuroendocrine tumors and other cancers.

Our multidisciplinary team includes specialists in nuclear medicine, medical oncology, radiation oncology, radiology, surgery, nursing and pharmacy who work together to develop a personalized treatment plan for every patient. From diagnosis and treatment through follow-up care and survivorship, we coordinate every step of your care to ensure you have access to the expertise, technology and support you need.

For a second opinion or to learn more about theranostics and other treatment options, call the University of Cincinnati Cancer Center at 513-585-8222.