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Lutetium-177 PSMA Prostate Cancer Treatment in Germany

Dr. Farrukh Ahmed image
Written by
Dr. Farrukh Ahmed

Germany has become one of the world’s most requested destinations for Lutetium-177 PSMA therapy. As is known, PSMA 177Lu treatment has become a targeted and promising option for advanced prostate cancer treatment and beyond.[1][2] Therefore, international patients are drawn globally by leading researchers, high-class reputation & standards, and availability.[3]

This matters because when prostate cancer progresses, time, coordination, and quality controls are everything. Patients and families are not just comparing science; they’re comparing wait times, price, logistics, and clinic reputation.[4][5] The goal of this page is to help you make a confident decision about arranging Lu-177 PSMA in Germany specifically.

Why Germany for Lu-177 PSMA?

Germany for Lutetium 177 TherapyGermany stands out for Lu-177 PSMA not just because treatment is available, but also because the ecosystem surrounding it makes access faster, more reliable & safer, and easier for international patients. If we summarize the main reasons for visiting Germany for targeted prostate cancer radiation, it looks like:

  • Experience with Lu177 since the finding;
  • Ongoing trials shaping the future;
  • Availability of centers & nuclear physitians;
  • Custom usage beyond standard indications;
  • Quality control.

Having positive feedback from past travelers is another factor. Check out our Lutetium-177 success story. The pages help to see the process from inside and gain real pre-treatment expectations.

In this section below, we focus on the practical advantages of Lu177 treatment in Germany, which directly impact your experience.

Germany’s Role in PSMA-617 Pluvicto

The main fact patients should know is that Germany isn’t just delivering Lu-177 PSMA—it helped invent it back in 2012.[6] PSMA-617, the small molecule behind Pluvicto, was developed by the German Cancer Research Center in collaboration with Heidelberg University Hospital. Based on this discovery, German clinics have been treating patients since 2013, giving the ecosystem over a decade of hands-on experience so far.

German doctors remain highly active in PSMA research and multicenter studies.[7] This depth of R&D activity means you’re tapping into a system that routinely publishes, runs large trials, and adopts updates quickly.[8]

Dense Network of Nuclear-Medicine Centres

Nuclear Medicine in GermanyWhat makes treatment in Germany feel “easy” for Lu-177 PSMA isn’t just technology - it’s how much of it is concentrated in one place. You’ve got 36 university hospitals anchoring care across the country, each with established nuclear-medicine departments.[9] Additionally, there is a wide range of certified outpatient and private centers in major metropolitan areas.[10] In practical terms, that means more calendars to choose from (Munich, Berlin, Heidelberg, and beyond), as well as real backup options if your plans need to be adjusted.

Germany’s ecosystem shortens the path from scan to therapy. The country operates 32 cyclotrons in clinical settings (the largest share in the D-A-CH region), strengthening local isotope supply chains.[11] PSMA-PET agents continue to expand (e.g., Illuccix approval in Germany in 2025), and EU approval of Pluvicto arrived on December 13, 2022.[12][13] This enables the routine use of Lu-177 PSMA in eligible patients at accredited centers.

Strict Radiopharmaceutical Quality Control

Radiopharmacies in Germany work under the EU’s GMP rule-set, including Annex 3 (Manufacture of Radiopharmaceuticals).[14][15] It has clean-room classifications and batch-release procedures tailored to sterile radiopharmaceuticals.[16] In practice, this means maintaining documented batch traceability and adhering to aseptic standards aligned with EU guidance, which inspectors use during audits.[17]

Access to Additional Infrastructure

Having developed supporting diagnostic capacity is essential for pre-procedure qualification and post-Lu177 control. The latest national PET survey reported 154,400 PET scans in 2021, with 94% of these being PET/CT scans, and theranostics accounting for 13%.[18] The overall PET volume increased by 48% from 2017 to 2021, indicating that the clinical infrastructure is active and expanding. Having developed supporting diagnostic capacity is essential for pre-procedure qualification and post-Lu177 control.

Who Qualifies for Lu177 in Germany?

If you’re considering Lu-177 PSMA in Germany, eligibility begins with the same medical basics used worldwide, and then receives an additional layer of structure. Generally, candidates have metastatic castration-resistant prostate cancer (mCRPC), so it’s an advanced stage.[19] Patients must demonstrate PSMA-positive disease on PSMA-PET, with no “problem areas” that are PSMA-negative.[1] You’ll also need labs that are “fit-for-treatment” and a performance status within a functional range.

Learn more about the current practical settings where Lu-177 PSMA prostate cancer treatment is practiced globally here.

Little German Specs

Where Germany differs is in how tightly these checks are applied and coordinated. Most centres follow the EANM/SNMMI Lu-PSMA therapy guideline to the letter: imaging is read against agreed criteria, oncology history is reviewed, and suitability is confirmed in a multidisciplinary tumour board (nuclear medicine, urology/oncology, sometimes radiology).[20] This process provides international patients with a clear, documented “yes/no” decision and a treatment plan that aligns with European best practices.

Another German nuance you may encounter is dual-tracer imaging in cases with borderline results.[21] While not mandatory for everyone, some centres add FDG-PET alongside PSMA-PET when they suspect mixed biology. Why? Studies show that PSMA-negative/FDG-positive (“discordant”) disease tends to track with poorer outcomes, so clinics want to rule that pattern out before committing you to Lu-177 PSMA or at least set expectations early.[22]

Indications Available Exclusively in Germany

Beyond the standard label, Germany offers structured ways to treat additional, carefully selected cases or to enroll patients in ongoing trials. Physicians can use individual treatment attempts (Individuelle Heilversuche) when evidence is promising but not yet approved for a given scenario.[23] These are documented, risk-managed “off-label” uses permitted under German medical law for patients with limited options. In prostate cancer, this pathway helped German centres treat PSMA-positive patients years before EU authorisation and still supports nuanced decisions today (for example, extended cycles or re-challenge after a break, when labs and imaging remain favourable).[24][7]

Crucially, this isn’t improvisation, but it is evidence-guided and audited.[7] German groups publish their outcomes. It covers multicentre analyses of early nationwide experience and newer cohorts showing that extended Lu-PSMA therapy and re-challenge can be delivered safely in selected prostate cancer patients, with meaningful survival and maintained efficacy signals.[25] These data give tumour boards concrete benchmarks when considering non-standard courses for individuals who are still likely to benefit.

If you prefer to stay strictly within research, German hospitals are actively involved across the Phase 3 program, moving Lu-PSMA earlier in the disease course and exploring combination strategies. The examples include PSMAfore (taxane-naïve mCRPC) and PSMAddition (metastatic hormone-sensitive disease).[26][27] It provides selection rules that clinics follow when treating on-label, off-label, or within a study, ensuring that your case is screened with the same disciplined criteria.

New Lutetium 177 Trials in Germany

For a concrete example of how Germany experiments responsibly at the forefront of care, consider the University Hospital Essen trial, registered as CTIS ID 2022-500838-28-00.[28] The study calls LUPUS, where doctors deliver Lu-PSMA-617 directly into the pelvic arteries before operation for men with high-risk localized or locally advanced prostate cancer who are candidates for prostatectomy surgery.[29] The goal is straightforward but ambitious: test the safety and logic of giving targeted radiation to the tumor bed before the prostate is removed, and see how that affects imaging and surgical outcomes.

Why does this matter to a prospective patient? Because it shows the scope of options available in Germany beyond standard metastatic use. Neoadjuvant approaches, such as Essen’s, could help shrink or sterilize the disease earlier.

How the Process Works Step-by-Step

Think of Germany’s pathway as a clean, four-step loop: we confirm you’re a fit, secure firm dates, deliver therapy, and then track recovery and provide recommendations. Here’s how it actually plays out, so you can book flights and hotels with confidence.

Step 1: Case Review

It starts with a rapid remote review of your medical situation. You or your oncologist shares a recent PSMA PET-CT scan report (images in DICOM format, if available; ideally from the last 2–3 months).[19][30] Additionally, it required providing a summary of treatments and medications, as well as fresh lab tests (typically: CBC, renal, and liver, preferably no older than 14 days).[20] A nuclear medicine physician screens the file and, in most centers, presents it to a multidisciplinary tumor board. You’ll get a written decision—yes, yes with conditions (for example, repeat labs or update imaging), or not eligible—along with a quote. Do you not have a recent PSMA PET scan, or is the scan outdated? We can arrange one on arrival in Germany before the 1st cycle, keeping everything on a single itinerary.

Step 2: Slot Schedule

Once you approve the plan, request actual therapy dates from your chosen hospital. You’ll typically receive a short window with two or three options, along with instructions on how to make a payment to reserve the Lu-177 dose and day of treatment. It’s also essential to arrange practical details, such as airport transfers and hotels that comply with radiation safety guidelines, so you’re not left guessing.[31][32] Spacing is set upfront: Lutetium 177 PSMA cycles are typically planned every 6–8 weeks, but may vary depending on medical factors.[33]

Step 3: Therapy Time

Treatment day is designed to be calm and predictable. You check in, repeat vitals and labs, and meet the treating nuclear medicine doctor. After pre-medication and IV setup, the Lu-177 PSMA infusion itself takes about 30–45 minutes.[34] Most centres keep you for 2–4 hours of observation and radiation-safety checks, then discharge you the same day with written instructions, emergency contacts, and your next appointment. Depending on internal clinical protocols, some German centers may keep you hospitalized for 2-3 days due to the need for radiation protection and better follow-up.[35][36] If you’re combining a PSMA PET scan and the first cycle in one trip, imaging comes first; once the team signs off, therapy proceeds without adding extra travel days. For those seeking administration details, dosage, and more technical information on Lu177 PSMA, including an explanation of its mechanism of action, visit our pages covering general Lutetium 177 principles and its specific usage in prostate cancer.

Step 4: Between Cycles

You can fly home the next day or after a brief rest.[37] After-therapy follow-up is light but structured: around weeks 3–4, you’ll undergo local labs and a PSA check, followed by a short online review to discuss side effects and medications.[38] You will return approximately every 2 weeks for the next cycle, as scheduled.[39] Many German clinics assess response with PSMA PET-CT after 2–3 cycles (earlier if PSA or symptoms suggest it).[40] If blood counts dip or side effects linger, the doctor may delay, adjust the dose, or plan a later re-challenge.

Best Lu177 PSMA Therapy Centres in Germany

Seeking the most reliable places to start Lu-177 PSMA treatment in Germany? Below are vetted centres with proven experience and strong scheduling capacity, so you can compare options and book with confidence.

University Hospitals for Lu177

Select a university and an academic hospital if scientific activities and ongoing clinical trials are your primary considerations. Such a clinic might offer slower arrangements and sometimes limited flexibility. At the same time, patients can access the latest innovations and adhere to strict protocols.

University Hospital Rechts der Isar Munich

University Hospital Rechts der Isar in Munich is a research-led centre with a dedicated theranostics program, strong imaging capabilities, and an established workflow for Lu-177 PSMA—ideal if you want academic rigor combined with smooth coordination. The service operates within the Department of Nuclear Medicine, under the chairmanship of Prof. Dr. Wolfgang Weber and Prof. Dr. Matthias Eiber, who serves as the head of theranostics and leads the Lu-177 PSMA care team. The team is actively running PSMA studies—e.g., a current TUM Klinikum rechts der Isar trial on biomarkers during PSMA radioligand therapy (NCT07118436).[41]

University Hospital Heidelberg

University Hospital Heidelberg is the flagship institution where PSMA-617 was first developed. This hospital is a go-to when you want pioneering science with routine throughput. Care is delivered by the Department of Nuclear Medicine, led by Prof. Dr. Uwe Haberkorn, in close collaboration with urology and oncology, the same teams responsible for early PSMA-617 dosimetry and clinical reports.[42] Heidelberg’s urology service alone manages about 2,000 prostate cancer patients per year, and its nuclear medicine group authored seminal PSMA papers that seeded today’s protocols. It is strong evidence that you’re treated in a high-volume, research-active setting.[43]

University Hospital Saarland Homburg

University Hospital Saarland-Homburg is a strong choice for those seeking an academically driven Lu-177 PSMA program, offering everything under one roof. A dedicated PSMA radioligand therapy service and on-site PSMA-PET-CT for fast triage and follow-up. Care is delivered in the Department of Nuclear Medicine, led by Prof. Dr. Samer Ezziddin. The team published a pilot study of Lu-PSMA + enzalutamide, showing PSA responses in 100% of patients and 70% partial remissions, which highlights the active research and ongoing protocol refinement.[44]

University Hospital Ludwig-Maximilians Munich

University Hospital LMU Munich is a powerhouse for Lu-177 PSMA, boasting a dedicated Department of Nuclear Medicine and a mature theranostics workflow, which facilitates eligibility review. PSMA-PET and therapy are coordinated under one roof. The unit, led by Prof. Dr. Rudolf Alexander Werner, publicly lists Lu-177-PSMA therapy among its services and offers both outpatient and inpatient care. Research output is active and ongoing, as evidenced by LMU authors' contributions to PSMA-related imaging response papers, as well as prospective abstracts, which provide patients with access to teams that shape practice standards.[45][46]

University Hospital Essen

University Hospital Essen is a top choice for those seeking an academic theranostics team with genuine depth in Lu-177 PSMA and seamless imaging-to-therapy workflows. Treatment is conducted in the Department of Nuclear Medicine, led by Prof. Dr. Ken Herrmann, who frequently publishes on PSMA RLT and imaging standards. Recent output includes: 1) JNM multi-center paper on re-challenge/extended Lu-PSMA; 2) the PSMAfore phase-3 program; and 3) LUPUS trial testing intra-arterial 177Lu-PSMA-617 before prostatectomy.[47]

Private Clinics Offering Lutetium 177

Suppose you are looking for a wise combination of treatment quality without compromising comfort and service. Private centers offer more flexible Lu177 therapy and a personalized approach to each case.

Helios Hospital Berlin-Buch

Helios Hospital Berlin-Buch is a solid private option if you want clear, patient-facing Lu-177 PSMA pathways, along with strong imaging capabilities on-site. The therapy is run in the Department of Nuclear Medicine, led by Prof. Dr. Stefan Dresel. The hospital appears in Novartis’ RLT centre finder as a site offering therapy and PET-CT diagnostics —evidence of an established program rather than an ad-hoc service.[48]

Vivantes Hospital Berlin-Neukolln

Vivantes Hospital Berlin-Neukölln is a good choice if you want an inpatient, tightly run theranostics unit with all services on one campus. Lu-177 PSMA is performed by the Nuclear Medicine Clinic, led by Prof. Dr. Michail Plotkin. The nuclear medicine unit features 10 single rooms dedicated to radionuclide therapies, including Lutetium treatment, ensuring smooth scheduling and radiation safety logistics.[49]

Helios Hospital Krefeld

Helios Hospital in Krefeld is a practical private option for those seeking an inpatient Lu-177 PSMA pathway, featuring on-site PSMA PET scans and precise scheduling. The therapy runs in the Department of Nuclear Medicine, led by Dr. Mostafa Shahinfar. As proof of its scale and infrastructure, Helios Krefeld is a tertiary hospital with over a thousand beds.

Clinic Choice: Key Practical Differences

Not every Lu-177 PSMA program runs the same playbook, and that’s why a clinic that’s perfect for one patient may be a poor fit for another. Medical centres differ in their eligibility protocols (e.g., whether they require dual-tracer PSMA+FDG in borderline cases, how strictly they apply liver-uptake thresholds, or whether they accept prior imaging older than 8–12 weeks).[19][50] Day-case vs short inpatient stays, dose-modification rules, and how fast tumour boards convene also vary; those details can be the difference between starting in two weeks or two months.[35]

Costs are another factor. Some hospitals quote a package price per cycle (radiopharmaceutical, day ward, labs), while others break down the prices of PET-CT, lab work, doctor fees, and support. Location matters: a clinic 20 minutes from a major airport with hotels that meet radiation safety guidelines can reduce travel stress and the need for extra nights.[31] In practice, matching your case to the right protocol, price structure, city logistics, and physician experience is what turns a good plan into a smooth treatment journey.[51]

What Makes a Centre Eligible

Airomedical employs a multi-factor, pay-to-play proof model: only clinics with a verified identity and sufficient data are eligible to enter the recommendations. Listings are derived from our primary factors, which include the integrated AiroScore (accreditation, scope, and service readiness), UserScore (credibility-weighted reviews), a clinical quality dataset (risk-adjusted outcomes, safety, and access), plus editorial verification.

For Lu-177 PSMA in Germany specifically, centres must demonstrate GMP-compliant radiopharmacy access, PSMA-PET-CT capacity, adherence to EANM/SNMMI protocols (including eligibility, dosing, and monitoring), and documented experience (e.g., trial activity, complication rates, and on-time scheduling).

Cost for Lutetium 177 Treatment in Germany

Regardless of the DRG price system in Germany, costs vary widely across locations due to the type of centre, care setting, local demand/waitlists, city costs of operations, doctor’s fees, and whether key diagnostics are included.[52][53] Economic situation and updated national guidance can also cause quotes to fluctuate over time.

Lu177 Therapy Costs per Medical Centre

Here, we compare the cost of Lutetium 177 PSMA treatment at different clinics at a glance. Patients often use the financial factor as one of the criteria for choosing a hospital, which is quite reasonable.[54]

ClinicCost per cycle
University Hospital Rechts der Isar Munich25,000-35,000 €
Helios Hospital Berlin-Buch20,540-26,063 €
University Hospital HeidelbergFrom 29,000 €
University Hospital Saarland Homburg18,200-24,500 €
University Hospital Ludwig-Maximilians Munich27,000-38,000 €
Vivantes Hospital Berlin-NeukollnFrom 24,350 €
University Hospital EssenFrom 27,000 €
Helios Hospital Krefeld20,500-25,000 €

Inclusions vs. add-ons

Every centre prices Lu-177 PSMA a bit differently, so clarify what your per-cycle quote actually covers and what it doesn’t. As a rule of thumb, inclusions usually cover the radioligand dose, medical team time on treatment day, day-ward use, and routine safety checks.[19] Airomedical has tailored medical offerings, such as those for Lu177 therapy, which display program content at a glance.

Add-ons are items that often vary by clinic and case, including pre-cycle imaging (e.g., scintigraphy, PET scan if a fresh scan is required), extra inpatient nights, non-standard laboratory tests or medications, and non-medical services.[55] Airomedical patients always have detailed cost estimates, including all the covered items.

Payment options

Most German hospitals handle private, self-pay cases for internationals: you’ll typically pay upfront to secure the slot.[56] Standard methods include bank transfer and major credit/debit cards. You’ll receive a formal invoice, and upon request, a medical necessity letter for your records.[57] Private arrangements are sometimes more accessible and faster compared to the situation when patients can’t cover their expenses out-of-pocket.

Private insurance policies sometimes reimburse part of the costs on a case-by-case basis, but coverage is not guaranteed and depends on the specific circumstances.[58] There is an additional option to claim your health-related expenses for a tax deduction, which Americans commonly use.[59]

Germany vs. Other Destinations

Comparing Lu-177 PSMA for prostate cancer across countries isn’t theoretical; it can change when you start, what you qualify for, and how your care is delivered.[1][37] Start with a waitlist, eligibility rules, and access to on-site diagnostics vary widely.[1] Check regulatory safeguards and radiopharmacy standards, as they also differ, which affects dosing consistency and follow-up. Add travel time, and the “best” country becomes the one that fits your medical profile and timeline, not just the one with the cheapest quote.

Quick Compare Table

Use this table to compare Germany’s Lu-177 PSMA offering against other hubs on the factors that actually impact your experience: start time, per-cycle cost, and clinic density, as well as their practical experience with Lutetium. It’s a quick way to see where Germany leads, but where another destination might be a better fit for your budget or timeline.

CountryAccess speedCentre density*ExperienceCost per cycle
Germany2-4 weeksHighExtensive18,200-38,000 €
USA2-8 weeksHighExtensive45,000-55,000 $
UK6-12 weeksModerateModerate25,000 £
Canada12-18 weeksLowLow40,000 $
Denmark4–12 weeksModerateModerate27,500-53,000 €
Austria2-6 weeksHighExtensive24,500-45,000 €
Sweden8-16 weeksLowModerate-low35,000-50,000 €
Netherlands7-14 weeksModerateModerate- High42,000-56,000 €

*The parameter is not absolute but adjusted to the population size.

FAQ

What exactly is Lutetium-177 PSMA therapy?

A targeted radioligand treatment that binds to PSMA on prostate cancer cells and delivers Lu-177 radiation to kill them while sparing more normal tissue. It’s given in specialised nuclear medicine centres.

Is it approved in the EU & Germany?

Yes. The European Commission approved Pluvicto on 13 December 2022

Who is eligible for Lu177 in Germany?

Typically, men with metastatic castration-resistant prostate cancer that still expresses PSMA on PET/CT, after prior ARSI and taxane chemo (per EU label). Many German hospitals also state it’s for advanced cases after guideline-recommended options. But the actual usage is way beyond the on-label approval.

How do doctors in Germany confirm I’m PSMA-positive?

With PSMA PET/CT (e.g., 68Ga-PSMA-11). It must demonstrate sufficient uptake before initiating therapy.

How many cycles and what schedule are in Germany?

The EU label recommends 7.4 GBq every 6 weeks (±1) for up to 6 doses. At the same time, the actual recommendations might vary depending on the medical situation.

Is the Lutetium therapy inpatient or outpatient in Germany?

Administration is performed in controlled radiopharmacy areas. Many guidelines specify it’s provided inpatient with PSMA imaging, often done ambulatory. German local centre practice may vary.

What does it cost to self-pay in Germany?

Ranges vary by centre and what’s included. Examples of packages can range from €18,200 to €38,000 (depending on the case). Get an estimate from your chosen hospital.

Which German centres offer 177Lu PSMA treatment?

Multiple hospitals offer Lu-177-PSMA programs, including Charité Berlin, University Hospital Essen, Heidelberg (the origin of PSMA-617), and Helios Berlin-Buch, among others. Check each centre’s nuclear-medicine department for details in the clinic's profile.

Can I get additional or combination radioligand therapy in Germany?

Some centres individualise beyond six cycles or explore combinations (in trials), but the standard approved use is as above; decisions are made on a case-by-case basis.

Why is Germany popular for Lu-177-PSMA?

PSMA-617 originated from Heidelberg/DKFZ, and many German university hospitals have extensive experience and infrastructure in radiotheranostics for international patients. Lastly, the cost is quite competitive among developed countries.

References

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