Quadramet For Bone Metastasis

Quadramet [Sm-153] is a radioactive material approved for use in the treatment of widespread bony metastases from cancer. It is given as an outpatient as an intravenous injection. It can be used in patients who either have too many painful sites for conventional radiation to cover, or in a site that cannot receive any more external radiation treatment. It is NOT effective in any site except bone. The main side effect of Quadramet 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 received Quadramet, he or she may not be able to receive additional kinds of treatment if the blood counts remain low.

Because this is an injection of radioactive material into the bloodstream, there are precautions that must be taken at home. Althought 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 24 hours, 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 - Radiation Oncology for additional information.

2. For the first 12 hours after the injection, drink as much fluid as possible and urinate frequently, to clear excess radiation from your body

3. 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 and then rinsed with water if possible.

4. For 24 hours after the injection, flush the toilet twice after each use, and wash your hands carefully.

5. 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.

6. If you cut yourself, clean the cut immediately, and wash away any blood that might have been spilled.

Although Quadramet is very effective for bone pain, it does NOT work overnight. Some patients may actually have an increase in their pain in the first 3-4 days. Pain relief usually starts in 7-21 days. It is important to stay on your pain medicine until you actually start to feel better. You should continue to take any other medication that you use as prescribed. You will probably need to have your blood counts checked 2 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 Quadramet 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.