What is Strontium-89 Chloride: Uses, Dosage, Side Effects and More

Strontium-89 chloride is a radioactive medication that helps reduce bone pain in people with cancer that has spread to their bones. It's a specialized treatment that works by targeting areas where cancer cells are actively growing in bone tissue, delivering targeted radiation therapy directly to these painful spots.

This medication belongs to a group called radiopharmaceuticals, which means it combines a radioactive element with a medicine that your body can use. Think of it as a very precise tool that can find and treat bone pain where traditional pain medications might not be enough.

What is Strontium-89 Chloride Used For?

Strontium-89 chloride is primarily used to treat bone pain caused by cancer that has spread from other parts of the body to the bones. This type of cancer spread is called bone metastases, and it can cause severe, persistent pain that significantly affects your quality of life.

The medication is most commonly prescribed for people with prostate cancer, breast cancer, or lung cancer that has moved to the bones. It's particularly helpful when you have multiple areas of bone pain, as it can treat several painful spots at once throughout your body.

Your doctor might consider this treatment if traditional pain medications aren't providing enough relief, or if you want to reduce your dependence on strong pain medications like opioids. It's not a cure for cancer, but it can significantly improve your comfort and daily functioning.

How Does Strontium-89 Chloride Work?

Strontium-89 chloride works by mimicking calcium in your body, since strontium is chemically similar to calcium. When injected into your bloodstream, it naturally travels to areas of your bones where there's increased activity, which is typically where cancer cells are growing.

Once it reaches these active bone areas, the strontium-89 releases targeted radiation that damages the cancer cells causing your pain. This radiation has a very short range, so it mainly affects the problem areas without significantly harming healthy tissues nearby.

The process is gradual and gentle. You might start feeling pain relief within 1-2 weeks, with maximum benefit often occurring around 3-4 weeks after treatment. This is considered a moderately strong treatment option that can provide relief for several months.

How Should I Take Strontium-89 Chloride?

Strontium-89 chloride is given as a single injection into a vein, usually in your arm, by a healthcare professional in a hospital or specialized clinic. You won't take this medication at home, and it's typically given as a one-time treatment, though some people may receive a second dose after several months.

Before your injection, you don't need to fast or avoid eating. However, your doctor might recommend staying well-hydrated by drinking plenty of water before and after the treatment. This helps your kidneys process the medication effectively.

The injection itself takes just a few minutes, but you'll likely spend some time at the medical facility for preparation and monitoring. Your healthcare team will explain any specific instructions based on your individual situation.

How Long Should I Take Strontium-89 Chloride For?

Strontium-89 chloride is typically given as a single treatment rather than an ongoing medication. Most people receive just one injection, and the effects can last for several months, often 3-6 months or sometimes longer.

If your bone pain returns after the initial treatment wears off, your doctor might consider giving you a second injection. However, there's usually a waiting period of at least 90 days between treatments to allow your body to recover, particularly your blood cell counts.

Your doctor will monitor how well the treatment is working through regular follow-up appointments. They'll assess your pain levels, check your blood counts, and determine if and when you might benefit from additional treatment.

What Are the Side Effects of Strontium-89 Chloride?

Like all medications, strontium-89 chloride can cause side effects, though not everyone experiences them. Understanding what to expect can help you feel more prepared and know when to contact your healthcare team.

The most common side effects are related to temporary changes in your blood counts, since the radiation can affect your bone marrow where blood cells are made. Here are the effects you might notice:

• Temporary increase in bone pain - This can happen in the first few days after treatment as your body responds to the medication
• Fatigue and weakness - You might feel more tired than usual for several weeks
• Increased risk of infection - Your white blood cell count may drop, making you more susceptible to infections
• Easy bruising or bleeding - Your platelet count might decrease, affecting your blood's ability to clot
• Nausea - Some people experience mild stomach upset

These effects are usually temporary and gradually improve as your body recovers. Your healthcare team will monitor your blood counts regularly to ensure they return to safe levels.

Rare but serious side effects can include severe drops in blood cell counts that might require medical intervention. Additionally, because this is a radioactive medication, there are specific precautions about radiation exposure that your medical team will discuss with you.

Who Should Not Take Strontium-89 Chloride?

Strontium-89 chloride isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. This medication requires healthy bone marrow function and adequate blood cell counts to be used safely.

You should not receive this treatment if you have severely low blood cell counts, as the medication can further reduce these levels. Your doctor will check your complete blood count before considering this treatment.

This medication is also not recommended if you're pregnant or breastfeeding, as the radiation can harm a developing baby. Women of childbearing age should use effective contraception and discuss family planning with their healthcare provider.

People with certain kidney problems might not be good candidates, as the medication is processed through the kidneys. Your doctor will evaluate your kidney function before treatment.

Strontium-89 Chloride Brand Names

Strontium-89 chloride is available under the brand name Metastron. This is the most commonly used formulation of this medication in clinical practice.

Since this is a specialized radiopharmaceutical, it's only available through specific medical facilities that are licensed to handle radioactive materials. You won't find this medication at regular pharmacies.

Strontium-89 Chloride Alternatives

If strontium-89 chloride isn't suitable for you, there are other treatment options available for bone pain caused by cancer. Your doctor can help you explore these alternatives based on your specific situation.

Other radiopharmaceuticals include radium-223 (Xofigo), which works similarly but is specifically approved for prostate cancer that has spread to bones. Samarium-153 (Quadramet) is another option that works on the same principle as strontium-89.

Non-radioactive alternatives include bisphosphonates like zoledronic acid, which can help strengthen bones and reduce pain. External beam radiation therapy can target specific painful areas, and various pain management approaches including medications and supportive care can also provide relief.

Is Strontium-89 Chloride Better Than Radium-223?

Both strontium-89 chloride and radium-223 are effective treatments for bone pain from cancer, but they work slightly differently and are used in different situations. The choice between them depends on your specific type of cancer and overall health condition.

Radium-223 is specifically approved for prostate cancer that has spread to bones and may actually help people live longer, while strontium-89 is primarily focused on pain relief and can be used for various types of cancer that have spread to bones.

Strontium-89 is typically given as a single injection, while radium-223 is usually given as a series of six injections over several months. Your oncologist will consider factors like your type of cancer, extent of bone involvement, blood counts, and overall health when recommending the best option for you.