At Theranostic Physicians, our blog is the long-form companion to our practice. It is where Dr. Ishita B. Sen and her team at Fortis Memorial Research Institute, Gurugram, write candidly about radioligand therapy, theranostic imaging, and the clinical reasoning behind every treatment decision. The pieces here are written for two audiences at once — patients and families navigating advanced cancer, and the referring oncologists who send those patients to us — which is also why they avoid both the jargon trap and the over-simplification trap that plague most healthcare writing.
A definitive primer on Actinium-225 PSMA — mechanism, eligibility, response rates, and how it compares to beta-emitter Lu-177.
When to use beta, when to escalate to alpha, and where Tb-161 fits — a head-to-head comparison framed for treating physicians and informed patients.
The consolidated reference on Tb-161 — supply chain, treatment cycles, dosimetry workflow, comparison with Lu-177, and answers to the questions patients and referring oncologists ask most.
Lu-PSMA, Ac-225, Tb-161 — radioligand therapies for advanced and metastatic prostate cancer.
When prostate cancer presents with limited (oligometastatic) spread, Lu-PSMA can be deployed as a targeted intervention — not a salvage option. A clinical perspective on patient selection.
The case for considering Actinium-225 PSMA earlier in the prostate cancer pathway, before patients have exhausted chemotherapy options.
Cost transparency for patients evaluating Pluvicto-equivalent therapy abroad. What the price actually covers — and where Indian centres genuinely undercut Western pricing.
A comprehensive patient-facing guide to prostate cancer — biology, staging, treatment options, and where nuclear medicine fits into the pathway.
How targeted alpha therapy reshapes the treatment calculus for men with mCRPC who have progressed on hormonal and beta-radioligand therapy.
The clinical case for Lutetium-177 PSMA as standard of care in metastatic prostate cancer — efficacy, evidence base, and where it fits in the pathway.
A profile of Dr. Sen's clinical philosophy — why she favours an iterative, dosimetry-led approach over fixed-protocol thinking.
PSA is a starting point, not a verdict. What an elevated PSA actually tells your urologist and what comes next.
Imaging timing matters. When to repeat PSMA-PET, when to wait, and how interim scans inform whether to continue or escalate.
PSA, imaging, symptoms — three signals, sometimes contradictory. How we read them together to decide whether to continue cycles.
Three anonymised composite cases walking through PSA trajectory, imaging response, and tolerability over multiple cycles of Pluvicto.
The argument — and the evidence — for moving Lu-PSMA earlier in the treatment sequence than the post-chemotherapy positioning it currently holds.
Common, uncommon, and rare side effects of Lu-PSMA and Ac-PSMA — and how we screen for and manage each one.
What VISION and TheraP actually reported on Lu-177 PSMA outcomes — median response duration, overall survival benefit, and how to read the data.
PSMA expression is not universal. Why imaging the target before treating it is non-negotiable — and what to do when the tumour doesn't take up the tracer.
The physics behind why a single Ac-225 alpha decay does more cellular damage than a Lu-177 beta decay — and why 'more potent' isn't always 'better'.
प्रोस्टेट कैंसर सर्जरी के बाद जीवन प्रत्याशा, जीवन की गुणवत्ता और दीर्घकालिक स्वास्थ्य के बारे में हिंदी में पूरी जानकारी।
Median response duration, overall survival benefit, and the difference between 'extending life' and 'curing disease' — explained for families.
Long-term outcomes after radical prostatectomy — survival statistics, quality-of-life realities, and what the published data tells us across cohorts.
Why early detection matters more than any single therapy, and what every man over fifty should be doing about screening.
From PSA test to PSMA therapy — every decision point in the prostate cancer treatment pathway, mapped out for newly diagnosed patients.
Supply-chain logistics, regulatory landscape, and price differential have made India a destination for Pluvicto-equivalent therapy. The honest account of why.
The evidence behind moving Lu-PSMA earlier in the treatment sequence — PSMAfore, SPLASH, and the patient profiles where earlier intervention may meaningfully improve outcomes.
Bronchial and pulmonary NETs are a distinct PRRT-eligible group. Selection criteria, expected response rates, and the published evidence for this less-discussed indication.
Peptide receptor radionuclide therapy for GEP-NETs, PPGL, paediatric neuroblastoma, and other receptor-positive cancers.
Eligibility, expectations, and clinical context for patients evaluating peptide receptor radionuclide therapy for neuroendocrine tumours.
What to expect from admission to discharge on a PRRT cycle day — written for patients preparing for their first session.
The standard-of-care radioligand for somatostatin-receptor-positive NETs — mechanism, indications, and what 4 cycles of DOTATATE actually achieve.
Eligibility criteria explained — somatostatin receptor expression, disease progression, organ function, and how we triage referrals.
How I-131-MIBG is delivered for high-risk and refractory paediatric neuroblastoma — the protocol, the precautions, and the response data.
Why high-LET alpha radiation matters in micro-metastatic NET disease, and where Ac-225-DOTATATE is changing salvage outcomes.
Outcomes data from well-differentiated metastatic NETs treated with Lu-177-DOTATATE — what the literature and our cohort show.
The biology of NETs explains why traditional chemotherapy frequently fails — and why receptor-targeted radioligand therapy has become the cornerstone of treatment.
Success rates, response patterns, and the full clinical picture of peptide receptor radionuclide therapy for NETs.
When PRRT alone isn't enough — adding chemotherapy and the patient profile where the combination delivers better tumour control.
From carcinoid syndrome to functional secretion — what NETs look like clinically, and why diagnosis is so often delayed.
PPGL tumours overexpress somatostatin receptors — making PRRT a meaningful option for unresectable, metastatic, or progressive cases that have failed standard therapy.
Cycle-by-cycle recovery realities for PRRT patients — what the first 48 hours feel like, what to watch for in the first two weeks, and what 'back to normal' actually looks like.
Step-by-step walkthrough of the Ga-68 DOTATATE PET-CT scan — preparation, what happens on scan day, and how to read the report.
Why Tb-161 matters, how it differs from Lu-177, and where it sits in the prostate cancer pathway.
Beta + Auger emission, voxel dosimetry, and what the early VIOLET data suggests about Tb-161's edge in micro-metastatic disease.
Cross-resistance, biological plausibility, and what we're learning from the small but growing cohort of Lu-PSMA non-responders treated with Tb-161-PSMA.
How the TPPL–TerThera arrangement guarantees on-schedule Tb-161 cycles for international patients planning multi-cycle courses.
The honest answer is: 'in some patients, yes — but the case is still being built.' What we know now, and what trial data should clarify next.
Yttrium-90 transarterial radioembolisation for HCC, liver metastases, and transplant candidates.
How a one-and-done mapping approach to TARE has compressed treatment timelines and total cost — without compromising dosimetric precision.
Comparing transarterial radioembolisation (Y-90) and transarterial chemoembolisation across HCC and neuroendocrine liver metastases — eligibility, outcomes, and selection logic.
Y-90 microsphere therapy explained — how the radiation is delivered, what side effects to expect, and how outcomes compare to TACE.
A foundational explainer on TARE for liver tumours — how the catheter-delivered Y-90 microsphere therapy works and who is a candidate.
TARE as bridging and downstaging therapy in HCC patients on the transplant list — what the survival data and Milan-criteria conversion rates show.
A complete reference on Y-90 TARE — patient selection, mapping angiography, microsphere choice, dosimetry, and post-therapy follow-up.
How Y-90 TARE serves as bridge and downstaging therapy for HCC patients awaiting liver transplant — preserving Milan-criteria eligibility and disease control during the waitlist.
Real journeys from international patients who travelled for therapy at FMRI Gurugram.
An international patient's pathway guide to arriving in Gurugram, navigating logistics, and undergoing therapy at FMRI.
How Lu-PSMA, Ac-225, Y-90 and Tb-161 prices compare across India, the US, Germany, and Australia — and what the differential really represents.
Plain-language guides to nuclear medicine, theranostics, PET imaging, and what they all mean.
Why detector technology matters in PET imaging — and what next-generation digital PET/CT systems add to lesion-level sensitivity in PSMA and DOTATATE scans.
The unifying idea behind theranostics — see-and-treat with the same molecular target — and what it means for the future of oncology.
From diagnostic imaging to targeted therapy, the full arc of nuclear medicine in oncology — written for the curious non-specialist.
Honest, clinically grounded writing on what can go wrong — and how we screen for and manage it.
Salivary gland protection during alpha-PSMA therapy — what the early Botox-injection studies suggest, and how we counsel patients.
A side-by-side comparison of the toxicity profiles across the three major therapeutic isotopes used in radioligand therapy.
Every article on this blog is written or reviewed by Dr. Sen — one of India's most experienced theranostic physicians. She trained at AIIMS and completed a post-doctoral fellowship at Memorial Sloan Kettering Cancer Center, New York. Two decades into clinical nuclear medicine, she leads the largest Indian clinical experience in PSMA-directed radioligand therapy and is principal investigator on multiple Tb-161 and Ac-225 protocols.
Because this blog covers complex medical topics, we get asked the same handful of questions repeatedly. Here are honest answers — visible in the page and structured for AI-driven answer engines too.
Reading helps; talking to a clinician helps more. Whether you want a 30-minute consult, an independent second read on an existing PET scan, or to schedule a treatment cycle — every door is open.
One email a month with new writing from Dr. Sen and the team — clinical frameworks, literature reviews, occasional essays. No marketing, no list rentals.
Medical disclaimer All physicians and researchers profiled on this page hold appointments at the Department of Nuclear Medicine & Molecular Imaging, Fortis Memorial Research Institute, Gurugram. Theranostic Physicians Private Limited (TPPL) is the clinical practice entity through which they consult and treat patients. Treatment outcomes vary by individual case; clinical decisions are made on the basis of complete medical records, current imaging, and a multidisciplinary review.