Prostate Cancer Tops Male Cancers in Korea as New Isotope Therapy Marks 200 Treatments

Prostate cancer, the most common cancer among South Korean men, is adding patients every year as the population ages. Against that backdrop, lutetium-177 (Lu-177) prostate-specific membrane antigen (PSMA) radioligand therapy — introduced in Korea for the first time to treat metastatic prostate cancer that no longer responds to existing treatment — is showing results.

The Urologic Cancer Center at the Cancer Hospital of Seoul St. Mary's Hospital said on the 1st that it has administered the therapy a cumulative 200 times to 84 patients with metastatic prostate cancer since performing Korea's first Lu-177 PSMA treatment on Nov. 2, 2020, through the 21st of last month. The tally covers a little more than five years since the first case in November 2020.

Metastatic castration-resistant prostate cancer is a state in which the disease no longer responds to treatment that suppresses male hormones. As it progresses, treatment options narrow and the prognosis worsens, making it important to choose the appropriate therapy and the order in which it is given, based on the patient's prior treatment history and overall condition.

Lu-177 PSMA therapy is one of the newest standard treatments for prostate cancer patients. It exploits the fact that a protein called PSMA is expressed far more heavily in cancer cells — especially those that have already spread — than in normal cells.

Before treatment, imaging is used to confirm how strongly PSMA is expressed in the target tumor and how far the tumor has spread. Only patients in whom sufficient PSMA expression is confirmed receive an intravenous injection of a therapeutic radiopharmaceutical bound to the radioisotope lutetium-177.

The agent circulates through the bloodstream, attaches selectively to cancer cells and then emits radiation — beta particles — that acts only over a distance of a few millimeters, damaging the DNA of the cancer cells.

Because the beta particles travel only a short distance, the effect on surrounding normal tissue is relatively small. Because the same target used for diagnosis is also used for treatment, the approach is called theranostics, a term combining diagnosis and therapy.

Prostate Cancer Cases Climb Sharply After Age 50

Prostate cancer ranks first among cancers occurring in men. According to the "2026 Prostate Cancer Fact Sheet" released by the Korean Urological Oncology Society, new prostate cancer cases in Korea totaled 23,928 in 2023. That is roughly 2.2 times the 11,095 cases recorded in 2014.

Prostate cancer accounted for 15.0% of all cancers in men, surpassing lung cancer (14.5%) and stomach cancer (12.8%) to rank first among male cancers. It also ranked sixth among all cancers.

Incidence rises steeply with age. Cases are relatively rare among men in their 40s, but the increase becomes pronounced from the 50s onward, with patient numbers surging among men in their 60s, 70s and 80s. Compared with 2006, the crude incidence rate — the share of newly diagnosed patients within a given population group — rose 25.2% among men in their 50s, 51.0% among those in their 60s and 55.8% among those in their 70s in 2023.

Prostate cancer produces almost no symptoms in its early stages, so a substantial share of patients visit a hospital only after symptoms such as urinary problems or pain appear. When the cancer is found at an early stage while still confined to the prostate, however, the five-year survival rate exceeds 95%. How quickly it is detected while still asymptomatic therefore determines the prognosis.

The most practical method of early detection at present is the prostate-specific antigen (PSA) blood test. Because the test is simple and relatively inexpensive, medical researchers recommend regular PSA testing for men aged 50 and over.