Navigating Radioligand Therapy Infusion Days and At-Home Radiation Safety for Prostate Cancer
Published on September 8, 2026
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It can be alarming to hear that your cancer treatment involves putting radiation inside your body, but know that radioligand therapy is a highly targeted and effective treatment that directly attacks cancer cells. Understanding what actually happens on infusion day — when the cancer-fighting medicine is infused into your bloodstream — and what safety measures to take once you return home can help transform uncertainty and anxiety into manageable steps.
What Is Radioligand Therapy and How Does It Work?
Radioligand therapy falls under a new class of treatment called radiopharmaceuticals; these drugs deliver radiation therapy directly to the targeted cancer cells, limiting exposure and damage to healthy tissues. The treatment pairs a radioactive isotope with a ligand, a type of molecule that travels through the body until it finds the specific receptor protein it’s designed to attach to.
“It’s sort of like the key to a door,” says Daniel Sentana Lledo, MD, a medical oncologist with Dana-Farber Cancer Institute in Boston, adding that the medicine releases the radiation once the key is in place.
For prostate cancer, that door, or receptor protein, is called prostate-specific membrane antigen (PSMA), and it’s found on the surface of most prostate cancer cells. The radiation comes in the form of the radioactive isotope lutetium-177.
This treatment is different from external-beam radiation therapy (EBRT), which directs high-energy radiation beams from a machine outside the body to a specific, targeted area. While EBRT delivers radiation to both cancerous and healthy cells in an area of the body, radioligand therapy works from the inside to deliver short-range radiation to cells anywhere in the body with a certain level of PSMA — earning it yet another name you may hear: PSMA-targeted therapy.
As a radiation-based treatment, it still carries safety risks, such as exposing others to radiation. But the safety measures for radioligand therapy are well established, standard, and easy to follow. These include practicing good hygiene and avoiding close physical contact with others for several days after the procedure.
What to Expect on Infusion Day
Lutetium Lu 177 vipivotide tetraxetan (Pluvicto) is the only radioligand therapy approved by the U.S. Food and Drug Administration for metastatic prostate cancer, and it’s given through six infusions spaced six weeks apart. The treatment is “actually not that different from many of the infusions patients may have gone through already,” Dr. Sentana Lledo says.
The entire visit may take less than one hour, including the prep work you’ll go through before your infusion. To start, your care team will review your medical history, new or recent symptoms, and current medications. They’ll also take blood samples to check your blood cell counts, kidney function, and overall health. A nurse will measure your vital signs and monitor them throughout the whole process, and you may be given antinausea medication.
Make sure you arrive at your appointment well hydrated. This will encourage posttreatment urination, which helps prevent radiation from building up in the bladder. To ensure that you’re hydrated, you may also be given a small amount of fluid, like 250 or 500 milliliters of normal saline, says Amir Iravani, MD, a nuclear medicine physician with UCLA Health.
Pluvicto is administered through an intravenous infusion, delivering the medicine directly into your bloodstream. A nurse or other healthcare provider will insert an IV line into your arm or connect to a port if you already have one. The infusion itself is brief, typically complete within 10 minutes. “The nurses are going to be very careful in administering it and staying sterile,” Sentana Lledo says. “But you really should not feel anything differently.”
There is also a brief monitoring period before you’re released, says Scott Tagawa, MD, a professor of medicine and urology at Weill Cornell Medicine in New York City. “We make sure there’s no substance reaction, and usually for most centers, we wait until the patient urinates at least once,” he says. This precaution ensures that nobody is near you during what's called the first void, since the radiation in your urine, while much less than in your body, is not being shielded by your body, he says.
Also for radiation safety, any caregiver you bring with you will likely be asked to remain in a waiting area outside of the room during the infusion. If you ride home with them, or use a taxi or rideshare service, “try to be as far away as possible from the driver,” Sentana Lledo says. “We really discourage patients from using public transportation.”
At-Home Radiation Safety Protocols
You must follow some temporary safety protocols during the first week after you return home. This helps protect your loved ones while your body naturally clears the radiation.
Within the first couple of days, drink plenty of fluids and urinate as much as you can. “That helps clear what is not being absorbed by the tumor sites,” Dr. Iravani says. “We want the radiopharmaceutical to get cleared through the body as quickly as possible.”
During this time you'll also need to stay at least 3 feet away from other people most of the time. “I usually give the general rule: no more than an hour within the first couple of days,” Dr. Tagawa says. “Hugs, grandchildren playing on the lap — as long as it’s for minutes, no big deal.”
Sentana Lledo tells patients to think of it like COVID. “And it’s not that the moment someone comes within 3 feet of you that the person is radioactive and going to have problems,” he says. “It’s a cumulative exposure. But certainly, as much as you can do to minimize it is better.”
Other precautions to minimize radiation exposure include:
- Sleep in a separate bedroom from adults, children, and pregnant women for 3 days, 7 days, and 15 days, respectively.
- Sit when you urinate (in a separate bathroom, if possible), wipe any dribble with toilet paper, and flush toilets twice with the lid closed.
- Practice good hygiene, including washing your hands with soap.
- Wash clothes, towels, and bedding soiled with your body fluids separately from other people’s items.
- Don’t share towels, washcloths, and utensils with other people.
- Place any disposable items you use, such as undergarments, pads, and utensils, into a sealed plastic bag and put it in the garbage bin outside (don’t leave it in the house).
- Shower daily for the first seven days.
- Refrain from sex for the first seven days, and use contraceptives after that.
When to Call Your Care Team
It’s normal to experience mild side effects like dry mouth, nausea, fatigue, joint or back pain, and gastrointestinal issues. However, call your provider or a radiation safety officer if you experience:
- Fever or chills
- Shortness of breath
- Easy bleeding or bruising
- Uncontrolled nausea or vomiting
- Issues urinating
- Sore throat or mouth ulcers
- Infusion site reactions like pain, redness, swelling, blisters, and numbness or tingling
Resources We Trust
- Cleveland Clinic: Expanding Cancer Treatment With Theranostics
- Mayo Clinic: PSMA-Targeted Therapy: How Are Radiopharmaceuticals Used to Treat Advanced Prostate Cancer?
- National Cancer Institute: Radiopharmaceuticals: Radiation Therapy Enters the Molecular Age
- Centers for Disease Control and Prevention: Prostate Cancer Health Tips
- American Cancer Society: Treating Prostate Cancer That Doesn’t Go Away or Comes Back After Treatment
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Geiger D et al. Radioligand Therapy: Using a Targeted Approach to Treat Cancer. Duke Health. June 17, 2026.
- Dougherty B. 5 Things to Know About Radioligand Therapy. Dana-Farber Cancer Institute. November 3, 2025.
- Expanding Cancer Treatment with Theranostics. Cleveland Clinic. October 2, 2025.
- Ksiazek I et al. Role of Lutetium Radiogland Therapy in Prostate Cancer. Cancers. July 1, 2024.
- External beam radiation for prostate cancer. Mayo Clinic. July 26, 2025.
- Gregory SY. PSMA-targeted therapy: How are Radiopharmaceuticals Used to Treat Advanced Prostate Cancer? Mayo Clinic. January 21, 2026.
- About Your Pluvicto Treatment. Memorial Sloan Kettering Cancer Center. December 11, 2025.
- Stallard J. FDA Expands Approval of Pluvicto for Metastatic Prostate Cancer: Targets a Protein Called PSMA. Memorial Sloan Kettering Cancer Center. August 14, 2025.
- What To Expect With Pluvicto Treatment. Pluvicto. July 2026.
- Lutetium Lu 177 Vipivotide Tetraxetan (Pluvicto). UW Health. March 2024.
- Pluvicto. San Antonio Cancer Center.
- Pluvicto. Florida Cancer Specialists & Research Institute.
- A Comprehensive Guide To Administering Pluvicto. Novartis. September 2025.
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