Treatment Approaches

The preparation of a patient for therapy with a beta-emitting radiopharmaceuti-cal begins several days before the actual infusion. Fully informed written consent is necessary, and the patient must be told that there are rare deaths from this therapy, almost all in patients with unrecognized DIC. This author has found it useful to give the patient a consent form to take home and share with family and other concerned parties before he signs it. A bone scan is necessary before treatment if one has not been done for several months and must be abnormal in the painful sites to be treated. Correlative radiographs of the painful sites should be reviewed. A complete blood count and assay of fibrin split products a day before treatment are necessary. These radiopharma-ceuticals are very expensive, and one does not want to order them if they will not be used when a contraindication appears in the form of an abnormal laboratory test on the day of treatment.

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