Nuclear Medicine Therapy

Depending on the type of treatment you are having, you will be given specific instructions on how to prepare. It is always a good idea to ask questions to your health care team to make sure you understand if there are any special preparations or restrictions prior to treatment.

• You may need to stop taking certain medications several days or weeks before the nuclear medicine treatment^10,11
• Often, certain laboratory tests are done prior to treatment¹¹
• You will likely be asked questions about how you feel and about your daily activities to help your health care team determine how the therapy will be administered and also what level of precautions in your daily life will be necessary to reduce the radiation exposure of other people after your treatment¹¹

There are a number of precautions you will need to be aware of. A discussion with your health care team about your individual circumstances and treatment will be important. Please tell your doctor:

• If you are or may be pregnant. Many nuclear medicine services require all women of childbearing age to have a pregnancy test within 24 hours before therapy^10,11
• If you are breastfeeding^10,11
• If you are incontinent (have trouble controlling your bladder)¹⁰
• If you have nausea or feel like you might vomit¹¹
• If you are using any prescribed or over-the-counter medication for any reason
• If you had surgery, chemotherapy, or radiotherapy
• If you had nuclear medicine therapies in the past
• If you have any allergies (medicine, food, etc)

• Nuclear medicine treatments are typically performed in a medical clinic, in a private room with a private bathroom. Sometimes visitors are allowed to be with you for certain parts of the procedure
• The radiopharmaceutical may be delivered by an injection into a vein or artery, or given by mouth, depending on your treatment protocol.^6,7 In some cases, other medications may be given to you before or during the nuclear medicine treatment¹¹
• Depending on the type of therapy you are receiving, a single dose may be sufficient or several treatment doses may be required.¹⁰ Your health care team should provide this information
• During treatment, some people may feel pain or discomfort associated with an injection or the insertion of an intravenous drip. Depending on the type of treatment you receive, you may feel other discomfort related to treatment administration during treatment.¹¹ As with many medicines, individuals may react very differently, so it is always good to discuss any concerns or previous experiences with your health care team

It is always a good idea to ask questions to your health care team to make sure you understand any special precautions or restrictions that you need to be aware of following your treatment.

Can I go home after treatment?

• Depending on the type of treatment you are receiving, it may be performed on an outpatient or day patient basis, meaning that you will not need to stay in the clinic/hospital overnight.¹⁰ However, for some treatments, you may have to stay overnight or for a few days to make sure that any radioactive excretions are disposed of safely when they leave your body.¹⁰ If you are required to stay in a medical clinic, you may be placed in an isolation room (by yourself) for a few days to limit radiation exposure to other people¹¹
• The radioactivity level in your body will be checked regularly in order to decide when you can leave the medical clinic⁶

Do I need to take certain precautions?
As a nuclear medicine therapy patient, you may need to take some safety measures depending on the type of therapy you receive in order to protect yourself and other people from the radiation that you have been given.¹⁰ Common recommendations include:

• Drinking a lot of water as most of the radiopharmaceutical leaves the body when you urinate¹
• Using the toilet in a seated position, using toilet paper to wipe (including men) and wiping up any spilled urine with toilet paper, flushing the toilet twice after each use, and washing hands thoroughly after using the toilet¹⁰
• Washing your hands thoroughly before preparing food^10,11
• Showering daily to remove sweat, as bodily excretions or fluids may contain some radiation²
• Washing bed linen, towels, and clothes separately from those of other people in the family¹⁰
• Limiting the time spent in close contact with people and especially avoiding contact with pregnant women and small children. This could mean that you need to stay 1 arm's-length away from people, avoid public transportation, avoid sharing a bed with a spouse or partner, and not go to work for a period of time^10,11
• Not become pregnant, or father a child, for a certain period of time after some types of therapy¹²
• Breastfeeding is to be completely avoided for a period of time following nuclear medicine therapy¹²

What if I have to travel for treatment?
It is recommended to speak with your health care team regarding any special considerations when traveling. Depending on the type of treatment you are receiving:

• It may be necessary to wait a certain period of time before flying or using other modes of public transportation such as trains or buses to avoid close proximity to others.⁶ Similarly, if you are traveling by car, it may be recommended to sit by yourself in the back seat, away from the driver
• If you travel in the period immediately following discharge, you may trigger sensitive radiation detectors that can be found at airports and border crossing points. These detectors are designed to detect even low levels of radioactivity. The security authorities are aware of this possibility, and if you are likely to travel soon after discharge, your health care team should provide a written statement to carry with you describing the therapy and the radionuclide or radioisotope used¹¹
• It may be recommended to travel with your own bed linens or to use a mattress protector to avoid any potential contamination¹⁰

Who will follow up and how?

• Your health care team will follow up with you after treatment to see how you are feeling, to check how your disease is responding to therapy, and to see whether you have any side effects related to your treatment^13-15
• You will likely have regular follow-up consultations in the following weeks or months. Some of these follow-up consultations may involve imaging and laboratory tests. These consultations will take place either at the medical clinic or with your referring doctor.^13-15 In some cases, patients may require a life-long follow-up¹³