Radioactive P-32 is a material approved for use in the treatment of elevated blood counts from diseases such as polycythemia vera. It is given as an outpatient as an intravenous injection. It can be used in patients who no longer respond to chemotherapy, plasmapheresis, or phlebotomy, or in patients who cannot tolerate other treatments. It is NOT effective in any site except bone marrow. The main side effect of P-32 is to lower the blood counts. It cannot be given if either the white count or platelet count is too low. If a patient has had repeated doses of P-32, he or she may not be able to receive additional chemotherapy because of low counts.
Because this is an injection of radioactive material into the bloodstream, there are precautions that must be taken at home. Although the radiation dose is low, it is important that you take some common sense precautions to limit the radiation exposure to other people.
1. Blood and urine contain small amounts of radiation. Therefore you should NOT have any blood or urine test for 2 weeks, except in a true emergency. If you need one of these tests, or are admitted to the hospital, you MUST tell the doctors and nurses caring for you that you have had a radioactive injection, and ask them to call the Cancer Center for additional information.
2. You should not use a urinal or catheter if possible. If one of these devices is absolutely necessary, they need to be emptied very frequently.
3. For 2 weeks after the injection, flush the toilet twice after each use, and wash your hands carefully.
4. If your clothes or linen get either urine or blood on them, they should be washed immediately, and washed separately from other clothes. Unstained clothes can be washed as you usually would.
5. If you cut yourself, clean the cut immediately, and wash away any blood that might have been spilled.
Although P-32 is very effective in lowering blood counts, it has been reported that it may carry a very small risk of causing a cancer like leukemia or lymphoma. This is why we usually give P-32 only when there are no other good options for treatment. However, the risk of causing a cancer is very small, and may be no more than the risk from chemotherapy. In addition, it can take 8-15 years before a treatment-induced cancer might develop. You should continue to take any other medication that you use as prescribed. You will probably need to have your blood counts checked 2-4 weeks after your injection.
Keep these instructions with you for 1 week after your injection. Show them to any healthcare giver [doctor, nurse, lab tech, home health aide, etc] that you need to see. This is especially important if you get admitted to the hospital for any reason in the first week after your injection. If you or your doctor have any questions about
P-32 or these precautions, they should call the Cancer Center and speak to one of the radiation oncologists, preferably before any tests are ordered or done.