Theranostics Gives Hope to Patient with Stage IV Prostate Cancer

John Corbin relaxed in a chair. He looked like any other patient hooked to an IV. But his aggressive prostate cancer wasn’t just any other cancer, and his treatment wasn’t just any other therapy. The IV delivered a “radioactive heat-seeking missile” into his body – a substance that would find the cancer cells and destroy them, dodging his healthy cells in the process. The treatment is known as theranostics, and it’s changing the future of medicine.

The term “theranostic” has been around since 1998, but only in recent years is it gaining public awareness. A combination of “therapeutic” and “diagnostic,” a theranostic is a material or method that allows physicians to combine both diagnostic testing and treatment. The result is a powerful and highly precise option for diagnosing and treating many cancers, allowing patients to live longer, healthier lives.

For years, physicians have used nuclear medicine (radioactive substances) to visualize and diagnose malignancies (cancer) in various organs. Now, these substances that pinpoint cancerous cells can also deliver cancer-killing therapy, better sparing healthy tissue than older types of treatment.

For example, some cancers can be diagnosed earlier using theranostics, the malignant (cancerous) cells specifically identified, and then the cancer treated efficiently and without causing the same serious side effects as traditional cancer therapies. This is accomplished by using drugs known as radiopharmaceuticals, which are designed to deliver a 1-2 punch. One part of the drug identifies and travels to malignant cells; the other component is often a radioactive molecule that then provides the ability to see the malignancy on scans with precision or destroy the malignant cell once it’s been located.

Jeffrey Holzbeierlein, MD, physician in chief at The University of Kansas Cancer Center, further explains, “I think everybody is familiar with a PET scan. It is a scan that really helps us detect cancer cells, pretty much anywhere in the body. Now think about a scan that can detect a specific type of cancer in the body, and once you’re able to image it or detect it, then you can attach a molecule that can also treat it. That’s how I describe theranostics.” PET scans use an injected radiopharmaceutical to “light up” the cancer cells so physicians can the targeted treatment.

The technology is changing the landscape of cancer care as researchers develop an array of radiopharmaceuticals that can be used for various types of malignancies. In addition, some theranostics in development do not contain a radioactive molecule. Instead, they will seek out and deliver other types of molecules to treat diseases like Alzheimer’s, Parkinson’s and cardiovascular conditions.

Corbin was diagnosed with metastatic (widespread) stage IV prostate cancer in 2016. His life expectancy based on the diagnosis: 5 years. He began a standard-of-care hormone therapy and chemotherapy treatment, but it wasn’t enough to tame the cancer.

John’s doctor prescribed Pluvicto, a radiopharmaceutical that locates a substance known as PSMA, found on many prostate cancer cells. When the radiopharmaceutical finds and binds to PSMA, it penetrates the cell and releases an energized electron from its payload of radioactive lutetium. That electron damages the cancer cell’s DNA, destroying it from within.

Following treatment, patients need to semi-isolate for a few days to avoid exposing anyone else to radiation. However, this does not mean the treatment is unsafe. Radiation therapy, usually delivered via external beams that penetrate the body, has been part of standard cancer therapies for decades. Theranostics delivered at the cancer center are administered in safe facilities by highly trained staff.

The benefit of a radiopharmaceutical like Pluvicto is the ability to target cancer cells that have spread without sending multiple external radiation therapy beams through healthy tissue, explains Elizabeth Wulff, MD, the medical oncologist at the cancer center who treated John’s cancer. The number of infusions varies, depending on a number of factors, including the extent of metastasis (how far the cancer has spread).

Pluvicto, which was FDA-approved in 2022 and then approved for primary treatment (before other chemotherapy) in 2025, is one of an increasing number of theranostic drugs in use, and many more are awaiting FDA approval and in development for treatment of cancer and other diseases, including neurodegenerative (progressive loss of neurons that cause diseases including Alzheimer’s and Parkinson’s) and infectious diseases. The cancer center also offers treatment with another radiopharmaceutical, Lutathera, which is used for pancreatic and other neuroendocrine cancers (cancers that can develop wherever there are endocrine cells).

Corbin calls Pluvicto “super juice.” He says, “It’s like a video game. You get so many points, you get an extended game. And Pluvicto was like giving me extra credit and giving me extended time in this thing called life.” Now, a decade after his grim diagnosis, Corbin still enjoys gardening and cooking and is feeling good.

“John’s cancer is well controlled, and he doesn’t have any real symptoms at all right now,” Dr. Wulff says. “And most importantly, he’s here for these memories that he’s making.”