Lutetium 177 candidates: I had a... - Advanced Prostate...

Advanced Prostate Cancer

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Lutetium 177 candidates

Runner1957 profile image
11 Replies

I had a robotic prostatectomy in Oct 20. PSA started to rise in July 21. 1st PSMA PET scan was inconclusive so have just had another and waiting upon results. PSA now 12.3 10 weeks later. Is Lutetium 177 the best option available at the moment?

Live in the UK so private is the only option, I think. I have been given a budget of £12300 per session.

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Runner1957 profile image
Runner1957
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GP24 profile image
GP24

If there are just a few metastases you better destroy them with targeted SBRT radiation. The NHS may pay for that. See this study for SBRT radiation of mets:

jamanetwork.com/journals/ja...

Runner1957 profile image
Runner1957 in reply to GP24

Thanks, will find out on Wednesday.

tango65 profile image
tango65

If you never had distant metastases you should discuss radiation to the prostatic fossa and whole pelvis radiation associated with ADT.

Tall_Allen profile image
Tall_Allen

You should not use Lu-177-PSMA-617 if you do not have sufficient PSMA avidity - it can increase toxicity.

The possibly curative therapy you should try next is whole pelvic radiation with 2 years of ADT. That will probably be covered by NHS. This therapy was proven by the SPPORT trial:

prostatecancer.news/2018/10...

GP24 profile image
GP24 in reply to Tall_Allen

You have to be in an very advanced state to be able to use an FDG PET/CT to determine if you have tumor which is not PSMA avid. I understand Runner is still hormone-sensitive and I think an FDG PET/CT at a PSA value of 12.3 will not be "successful".

Tall_Allen profile image
Tall_Allen in reply to GP24

I did not mention an FDG PET scan for him. You seem to have imagined that.

CAMPSOUPS profile image
CAMPSOUPS

Lutetium 177 candidates

I'm going to ask a question that has been with me and the title of Runner1957's post is a good place to interject maybe.

Bone marrow. It seems even if anecdotally that LU-177 is tough on bone marrow and subsequent proper blood counts. Or, the marrow is not healthy enough, or compromised already.

Is there any restriction based on receiving treatment based on blood counts ?--probably of course.

Are there any pharmaceutical/medical interventions prior to treatment to better prepare the bone marrow for LU-177 ?

Engraver68 profile image
Engraver68

Hi

I am in UK 11 years on from prostatectomy, I had similar PSA so next stage was pelvic radiation then 2 years after bicalutamide tablet for a further 6 years before That failed in 2018.

Then started hormone injection and zytiga, lasted out till last September when I had further radiation to the one metastasis. So far all good. The reason for this timeline is to let you be aware that you have many other options in the bank before you get to consider Lutitium treatment. It's likely by the time you should be considering this it will be standard treatment in UK.

This site will keep you informed of what is available and upcoming, you are very early stage so keep all other options open before you jump into the last chance saloon!

db1966 profile image
db1966

Hi there. Was that quote from the hospital in Windsor?

Runner1957 profile image
Runner1957 in reply to db1966

I think I found it online but remember Windsor being an option. Good luck.

Janhpr profile image
Janhpr

We had a quote from Windsor £13000 + PMSA PET Scan £2500

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