Cesium (Cs)

Cesium is a chemical element and alkali metal that is not a canonical biological target but is highly significant in the fields of toxicology, oncology, and electrophysiology. In its ionic form (Cs+), cesium acts as a potent blocker of various potassium channels, most notably the delayed rectifier potassium current (IKr) and hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, which can lead to severe cardiotoxicity and life-threatening arrhythmias such as Torsades de Pointes [10, 11]. While stable cesium chloride has been erroneously promoted in alternative medicine as a high pH cancer therapy, this practice is scientifically unsupported and associated with significant safety risks, including cardiac arrest and severe electrolyte imbalances [13, 14]. Conversely, radioactive isotopes such as Cesium-137 and Cesium-131 are established therapeutic agents in clinical oncology, utilized as radiation sources in brachytherapy to deliver targeted treatment to localized tumors in the prostate or cervix [2, 7]. The primary pharmacological intervention for cesium exposure or internal contamination is the administration of Prussian Blue (ferric hexacyanoferrate), which acts as a sequestering agent to facilitate the fecal excretion of the metal and reduce its biological half-life [8, 16].

Other names

Cesium-137Cesium-131Cesium chlorideCs+Radiocesium

Prussian Blue (ferric hexacyanoferrate) acts as an ion-exchange resin that traps cesium ions within its crystal lattice in the gastrointestinal tract, preventing absorption and interrupting enterohepatic circulation to enhance fecal elimination [16].