Radium 223 is considered an effective treatment for advanced prostate cancer that has spread to your bones.

Radium 223 dichloride (also just called radium 223) is a radioactive substance that a healthcare professional can inject into your bloodstream to destroy prostate cancer that’s spread (metastasized) to your bones. It’s available under the brand name Xofigo.

Killing prostate cancer cells in your bones helps stop the cancer from spreading further or damaging healthy tissues.

Read on to learn more about when radium 223 is used for prostate cancer, how radium 223 works, and what to expect when you get radium 223 treatment for prostate cancer.

Radium 223 is meant to treat advanced prostate cancer that’s spread to your bones.

It may also help in the following situations:

Radium 223 is a type of radium that produces alpha particles. Alpha particles can break apart the DNA strands in cells made of two connected strands. This usually kills the affected cells.

Radium 223 is often effective in treating cancer that’s spread to bones because it imitates calcium.

Calcium often builds up in areas that have been injured or damaged by cancer cells. By acting the same way as calcium, injected radium 223 can also build up in areas with a lot of cancer cells. Because its alpha particles don’t travel very far, the radium 223 can kill the cancer cells while sparing nearby healthy tissues.

A 2018 study involving 48 people with prostate cancer found that 62.5% of people who received radium 223 reported less pain than they were experiencing before treatment.

Radium 223 can also help improve your long-term outlook with advanced prostate cancer.

Some reported side effects of radium 223 for prostate cancer can include:

  • changes in overall health and quality of life
  • bone pain
  • low red blood cell count (anemia)
  • difficulty with blood clotting (thrombocytopenia)
  • reduced bone marrow
  • short-term damage to sperm

To prepare for treatment with radium 223 for prostate cancer, you may first need to:

If you are planning to have a child, your doctor will likely tell you to wait 6 months in order to let sperm heal and regenerate.

Here’s what to expect before and during a radium 223 procedure for prostate cancer.

Before the procedure

A healthcare professional will call you into a private treatment room. You usually do not need to change into a hospital gown or receive any anesthesia.

During the procedure

A medical professional will disinfect the skin on your arm near the injection site and use a tourniquet to help make your veins easier to find.

They will then insert a tube, called a cannula, into your vein. The cannula is attached to a container filled with radium 223, which passes into your bloodstream.

In a few minutes, all of the radium 223 will be injected into your body.

After the procedure

If you’re feeling alright after the injection, you can usually leave right away.

A doctor may recommend that you do the following for the first few days after an injection:

  • Drink water to flush the radium 223 from your body.
  • Sit down when you urinate to keep radioactive material inside the toilet.
  • Consider using gloves when you wipe after having a bowel movement.
  • Flush the toilet twice to get rid of radioactive material.
  • Disinfect the toilet seat after each use.
  • Wash any clothing that gets urine or feces on it separately from other clothes.

Recovery from radium 223 injections is minimal.

You can usually go back to your daily activities right away, unless you have any severe side effects or allergic reactions to the injections.

It’s often recommended that you use contraception for 6 months following treatment with radium 223 because development issues for a fetus are a possible side effect, according to the injection’s prescribing information.

Based on a 2023 study conducted in the Netherlands, radium 223 costs between $43,000 and $57,000 for a six-cycle treatment.

Most health insurance plans cover a majority of the cost. Most government healthcare plans, such as Medicare, cover Xofigo for prostate cancer.

Some alternatives to radium 223 for advanced prostate cancer or treatments that can be combined with radium 223 include:

Here are some frequently asked questions about radiation for prostate cancer.

Does radium 223 improve survival in people with advanced prostate cancer?

Radium 223 is shown to improve survival when prostate cancer has spread to your bones. A 2021 study found that people who had six treatment cycles were 57% more likely to survive longer than a year after treatment than people who took fewer than six cycles.

And a 2022 study of over 1,100 people who received radium 223 for advanced prostate cancer found that those who survived longer than 2 years after treatment had a better quality of life and fewer symptoms because of the treatment.

What is the most effective radiation treatment for prostate cancer?

Intensity modulated radiation therapy is considered one of the most effective radiation treatments for prostate cancer.

This treatment directs highly concentrated beams at cancer cells to destroy them while leaving nearby healthy tissues alone.

Speak with your doctor about this treatment if you’re still experiencing symptoms related to prostate cancer, such as bone pain, especially if other treatments haven’t worked.