Lutetium-177 PSMA therapy for advanced prostate cancer, delivered at a UK specialist centre.
A targeted radionuclide therapy - Lutetium-177 linked to a PSMA ligand - that seeks out PSMA-expressing prostate cancer cells and delivers radiation directly to them. NHS-funded for eligible patients under NICE TA1041 since March 2025.
Indicative pricing
What Lutetium-177 PSMA therapy costs in the UK.
NHS-funded for eligible patients under NICE TA1041. Private courses are possible in a small number of centres - indicative ranges below.
In short
NHS-funded via NICE TA1041; a private course runs roughly £45,000–£70,000.
| Item | Indicative range | Typical duration | Cadence |
|---|---|---|---|
| Lutetium-177 PSMA - full course (NHS via NICE TA1041) | NHS-funded | 4–6 cycles | Every 6 weeks |
| Lutetium-177 PSMA - full course (private) | £45,000–£70,000 | 4–6 cycles | Every 6 weeks |
| Lutetium-177 PSMA - single cycle (private) | £9,000–£14,000 | Half-day | Outpatient |
| 68Ga- or 18F-PSMA PET-CT (eligibility) | £1,800–£2,800 | 90 min | 3–5 days |
| PSMA PET-CT restaging (per scan) | £1,800–£2,800 | 90 min | 3–5 days |
| Uro-oncology consultation | £300–£500 | 30–45 min | Same visit |
Prices vary by centre, by whether PSMA PET-CT is included, and by how many cycles are planned. Private availability is currently limited.
The problem
The right team, the right selection, the right conversation.
Lutetium-PSMA is a narrow, later-line treatment. The commonest mistakes are chasing it before eligibility is confirmed, or being told it will cure a disease it can only slow.
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Not sure you qualify?
NICE TA1041 needs both an ARPI and a taxane behind you, and PSMA-avid disease on PET-CT.
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Worried about side effects?
Dry mouth, dry eyes, fatigue and marrow effects are the honest realities. A specialist team walks you through them cycle by cycle.
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Want it done at a proper centre?
A nuclear medicine department licensed for Lutetium-177, working alongside uro-oncology and medical physics - not a generalist clinic.
When it helps
When Lutetium-PSMA is the right next step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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mCRPC after ARPI and taxane
Metastatic castration-resistant prostate cancer that has progressed after an androgen receptor pathway inhibitor and a taxane - the NICE TA1041 indication.
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PSMA-avid disease on PET-CT
PSMA PET-CT shows enough uptake - typically SUVmax >10 with disease at two or more sites - to make radioligand therapy worthwhile.
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Rising PSA on current therapy
Biochemical progression despite abiraterone, enzalutamide, apalutamide or darolutamide, with imaging or symptom progression.
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Symptomatic bone metastases
Painful, widespread PSMA-avid bone disease where systemic radioligand therapy may improve pain and quality of life.
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Chemotherapy no longer tolerable
Docetaxel or cabazitaxel has been used, or is no longer suitable, and further cytotoxic chemotherapy is not the right next step.
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Preserved organ function
Adequate bone marrow, kidney and liver function to safely receive four to six cycles of radionuclide therapy.
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Shared decision-making
You understand this is survival-extending, not curative - and want a specialist team to walk you through the trade-offs honestly.
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Red flag: cord compression or fracture
Sudden back pain with leg weakness, numbness or bladder trouble is a spinal cord emergency - same-day A&E, not a clinic booking.
Pathway options
Lutetium-PSMA is one option - not the only one.
What each option on the table actually involves - and which fits which pattern of disease.
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Standard Lutetium-177 PSMA-617
The VISION-trial regimen: 7.4 GBq IV every six weeks, up to six cycles, in a licensed nuclear medicine department.
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PSMA PET-CT selection
68Ga- or 18F-PSMA PET-CT to confirm PSMA expression and rule out dominant PSMA-negative disease before committing to therapy.
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Dosimetry-guided planning
Medical physics calculates dose to kidneys, salivary glands and marrow to keep therapy within safe organ limits.
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Combination pathways (emerging)
Trials combining Lutetium-PSMA with ARPIs, PARP inhibitors or immunotherapy - discussed if a suitable study is open at your centre.
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Radium-223 alternative
For bone-only disease where PSMA uptake is limited, radium-223 (Xofigo) may be a better fit - a separate radionuclide with a different profile.
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Best supportive care
Symptom control, palliative radiotherapy and specialist nurse input remain part of the plan regardless of whether radioligand therapy proceeds.
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Clinical trial referral
If you fall outside NICE TA1041 - for example pre-chemotherapy - a UK trial of Lutetium-PSMA earlier in the pathway may be an option.
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Consultation only
An honest second opinion on whether Lutetium-PSMA is realistic for your disease, or whether another line of treatment fits better.
Safety and side effects
What to expect between cycles - honestly.
Lutetium-PSMA is generally well tolerated for a cancer treatment, but the side-effect profile is real. What matters is knowing what is normal, what to watch for, and when to call.
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Dry mouth is very common
PSMA is expressed in the salivary glands, so 60–70% of patients notice xerostomia. For some it settles between cycles; for others it persists and needs long-term saliva substitutes.
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Dry, gritty eyes
Lacrimal glands also express PSMA. Dry eye is common - lubricating drops help and your team will screen for it at each cycle.
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Fatigue is expected
Most patients feel more tired for a week or two after each infusion. It usually improves before the next cycle.
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Nausea, constipation and back pain
Managed with anti-emetics, laxatives and simple analgesia. A short pain flare in the first few days is not unusual.
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Bone marrow effects
Anaemia and thrombocytopenia are the commonest blood changes. Grade 3–4 neutropenia or low platelets needing transfusion are less common but monitored at every cycle.
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Kidney function is watched closely
Hydration protects the kidneys during and after each infusion. Renal function is checked before every cycle and dosing adjusted if needed.
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Radiation precautions for 24–48 hours
Per UK MHRA and BNMS guidance: relative distancing from pregnant women, infants and young children for the first day or two after each infusion. The team writes it down for you.
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Rare serious effects
Pituitary or thyroid dysfunction, radiation-induced secondary malignancy and myelodysplastic syndrome are rare and typically delayed. They are part of the consent conversation.
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Red flags between cycles
Fever with low white cells, unusual bruising or bleeding, sudden weakness in the legs or bladder trouble - all reasons to call the acute oncology line the same day.
Reading your treatment notes
Your Lutetium-PSMA note in four parts. Read the last one first.
Whichever centre delivers your treatment, the letter your oncologist sends you keeps to the same shape.
A quiet reminder
Oncology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and eligibility summary
Why Lutetium-PSMA was offered - mCRPC after ARPI and taxane - and confirmation you meet the NICE TA1041 criteria.
- 02 Technique
Dose, cycle number and dosimetry
The activity delivered (7.4 GBq per cycle), which cycle number this is, and the dosimetry to kidneys, salivary glands and marrow.
- 03 Findings
PSA, bloods and imaging response
PSA trend, FBC, renal and liver function, and how PSMA PET-CT restaging compares with your baseline.
- 04 Impression
Plan for next cycle, precautions, review
Read this first: whether to proceed to the next cycle, radiation precautions to follow at home, and when your oncologist wants to see you.
Recognised by major UK insurers
Insurer cover for Lutetium-PSMA varies and is evolving following NICE TA1041. Many eligible patients are treated on the NHS; private cover depends on your policy and indication.
Frequently asked
Everything we get asked about Lutetium-PSMA therapy.
Quick answers on eligibility, VISION outcomes, side effects and cost.
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What is Lutetium-177 PSMA therapy (Pluvicto)?
It’s a targeted radionuclide therapy for advanced prostate cancer. Lutetium-177, a beta-emitting radioactive isotope, is linked to a PSMA ligand (PSMA-617). The PSMA ligand binds to prostate cancer cells that express PSMA on their surface, delivering cytotoxic radiation directly to the tumour while largely sparing normal tissue.
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Who is eligible under NICE TA1041?
Adults with metastatic castration-resistant prostate cancer (mCRPC) that has progressed after an androgen receptor pathway inhibitor (abiraterone, enzalutamide, apalutamide or darolutamide) AND a taxane chemotherapy (docetaxel or cabazitaxel), whose disease is PSMA-positive on 68Ga- or 18F-PSMA PET-CT - typically SUVmax >10 with disease at two or more sites.
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How well does it work?
The VISION Phase 3 trial showed median overall survival of 15.3 months with Lutetium-PSMA plus standard care versus 11.3 months with standard care alone - a hazard ratio of 0.62, or a 38% reduction in the risk of death. Median radiographic progression-free survival was 8.7 months versus 3.4 months. Around 30–40% of patients have a PSA fall of more than 50%.
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How much does it cost in the UK?
Since March 2025 it is NHS-funded per NICE TA1041 in eligible specialist centres. Private courses currently cost roughly £45,000–£70,000 for a full four- to six-cycle programme, plus PSMA PET-CT scans (£1,800–£2,800 each) and consultations. Private availability is limited.
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What is the treatment like?
Four to six outpatient infusions of 7.4 GBq Lutetium-177 PSMA-617, given every six weeks in a licensed nuclear medicine department. You go home the same day with anti-emetics, hydration advice and short radiation precautions for the first 24–48 hours.
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What are the side effects?
The commonest are dry mouth, dry eyes, fatigue, mild nausea, constipation, back pain, and lower blood counts (anaemia and low platelets). Serious effects - grade 3–4 low counts, kidney impairment, secondary malignancy or MDS - are much rarer but part of the consent discussion.
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Is Lutetium-PSMA a cure?
No. It is survival-extending, not curative. It is offered as an advanced, later-line treatment in mCRPC to extend life and improve quality of life for the right patients.
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Where in the UK is it delivered?
A small number of specialist centres, including UCLH, The Royal Marsden and The Christie among others. Delivery requires a nuclear medicine department licensed for Lutetium-177 therapy, uro-oncology input and on-site medical physics.
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Can I have Lutetium-PSMA before chemotherapy?
Not under NICE TA1041 - the current NHS indication is after both an ARPI and a taxane. Earlier-line use is being studied in clinical trials, and referral to a UK trial may be an option in some cases.
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When should I seek urgent medical help during treatment?
Fever with low white cells, unusual bruising or bleeding, sudden back pain with leg weakness or bladder trouble, or heavy dehydration all warrant same-day contact with your acute oncology team or A&E.
Related treatments
Looking for something else?
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Prostate cancer treatment
The full treatment pathway, from diagnosis to advanced therapy.
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Hormone therapy
Androgen deprivation and ARPIs for prostate cancer.
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PSMA PET-CT
The scan that confirms Lutetium-PSMA eligibility.
Learn more -
All tests
Every test and procedure we cover.
Learn more