Patients in South Puget Sound with metastatic prostate cancer now have access to leading-edge treatment closer to home, thanks to the launch of Pluvicto therapy. For Dr. Justin Suszko, a radiation oncologist with Providence Swedish Cancer Institute in Centralia, Pluvicto represents more than just a new treatment option – it is part of an exciting shift in how cancer care is delivered.
Dr. Suszko's journey into radiation oncology was anything but traditional. After medical school, he initially trained in diagnostic radiology, spending five years specializing in interpreting imaging studies such as X-rays, CT scans and ultrasounds. It was during his final year in medical school that an elective rotation introduced him to radiation oncology.
"I didn't even know what radiation oncology was at the time," Suszko said. "But I realized it was the perfect blend of imaging and patient care. You get to use advanced imaging to guide treatment decisions while still building relationships with patients and helping them through their cancer journey."
After completing his radiology training, Dr. Suszko went on to complete a second residency in radiation oncology, bringing his total medical training to nearly nine years. He has been practicing in South Puget Sound since 2018. That background has given him a unique perspective on emerging therapies such as Pluvicto, which combines advanced imaging with targeted radiation treatment.
Pluvicto is a targeted radiopharmaceutical therapy approved for patients with metastatic castration-resistant prostate cancer – a form of prostate cancer that has spread beyond the prostate and no longer responds to standard hormone therapy alone. The treatment belongs to a growing field knows as theranostics, which combines diagnostic imaging and therapy into a highly targeted approach.
Before treatment, patients undergo a specialized PET scan that identifies whether their cancer cells express a protein called prostate-specific membrane antigen (PSMA). If the cancer is PSMA-positive, Pluvicto can be used to deliver radiation directly to cancer cells throughout the body.
"Pluvicto is essentially injected into the bloodstream and travels to where the cancer is located," Suszko explained. "It targets areas that light up on the PET scan, including not only bone metastases but also disease in lymph nodes and other soft tissue."
Unlike traditional external beam radiation therapy, which treats specific areas, Pluvicto acts systemically, seeking out cancer cells wherever they may be located.
When Pluvicto first became available, patients often had to undergo multiple rounds of chemotherapy before becoming eligible. Today, treatment guidelines have evolved. Patients whose cancer has become resistant to hormone therapy may now be candidates for Pluvicto before receiving chemotherapy.
"That's been a significant advancement," Suszko said. "Chemotherapy has been around a long time, but it can come with substantial side effects. Pluvicto has shown strong results while generally being well tolerated."
The treatment process is relatively straightforward. Patients receive an intravenous injection approximately once every six weeks for up to six treatment cycles. Compared with many traditional cancer treatments, the process is brief and convenient. "Most patients come in, have their labs checked, receive the injection, and then go home." Suszko said.
Although the program is still new in South Puget Sound, early patient experiences have been encouraging. One of the first local patients treated with Pluvicto reported improvements after just two treatment cycles.
"It was scary at first to hear it was a nuclear option that was fairly new, but I heard that a lot of people had really good experiences going through it," this patient stated. "Over the next couple of days after getting the shot I could actually feel that it was working away, getting those bad cells out of there."
Prior to launching Pluvicto in South Puget Sound, many patients needed to travel significant distances – as far as Seattle – to receive treatment. "For patients living in rural communities or farther south in Washington, those trips can become a major burden," Suszko explained. "Being able to offer this treatment locally has made a tremendous difference."
Pluvicto is a part of a rapidly growing field of targeted radiopharmaceutical therapies. Researchers are developing similar treatments for additional cancer types, including neuroendocrine tumors and other malignancies.
"We're really seeing the future of cancer treatment evolve," Suszko said. "The ability to combine advanced imaging with therapies that can travel through the bloodstream and target cancer cells directly is opening a lot of doors."
As Providence Swedish continues expanding access to innovative therapies, patients in South Puget Sound can increasingly receive advanced cancer care close to home. For patients and families facing prostate cancer, that means greater access, less travel and new reasons for hope.
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