I’ve had a few requests for me to report on my Lu PSMA treatment. I was diagnosed a year ago with metastatic PCa, and my reaction to Degerelix and Lupron soon revealed that it was already castration resistant. I’ve been through most SOC treatments and started Lu-PSMA in November through the early access program. Here’s my experience so far.
My PSA was at 49 following docetaxel treatment in July, but began to rise. After starting aberaterone, it stabilized at 100 for three consecutive readings. Comparison of my Axumin and PSMA PET scans showed no discordant disease.
I got my first Lu PSMA treatment at UCLA on November 12. They hydrated me with saline IV so that I would flush the unbound Lu PSMA from my system quickly. At the end of the treatment they measured me with s as Geiger counter, which was a bit surreal.
I had inflammation of the PSMA avid sites the first few days, with the higher concentration sites having greater pain and the pain subsiding more slowly there. I was mildly to moderately fatigued for about a week. After that, pain at most of the sites was mostly gone with the exception of my right femur and hip.
Labs before and after the first treatment:
November 1: PSA 101, ALP 281, RBC 3.88
November 18: PSA 179, ALP 270, RBC 4.1
November 29: PSA 124, ALP 349, RBC 3.72
December 16: PSA 172, ALP 428, RBC 3,9
My second treatment was December 17. Same procedure snd dosage. Inflammation mainly in my right femur and hip. Fatigue had mainly subsided within 5 days. Following that treatment, my cancer pain is dramatically reduced. I still have a lot of joint stiffness, snd weakness in my legs. Pain is often completely controlled with ibuprofen and Tylenol. I’ve developed a stiff muscle in my left calf muscle and have occasional twinges of pain in my knees and coccyx.
Labs after second treatment:
January 7: PSA 167, ALP 367, RBC 3.31
I’m learning to ignore the higher PSA and ALP readings, and concentrate on the vastly improved clinical signs. My team, and Dr Aparicio told me that readings after the third treatment are more important. This makes sense to me.
Docetaxel has a half life of 12 hours, so PSA from cell death should be flushed from the system within two weeks. Lu has half life of 7 days, so is still actively killing cancer 3, weeks after treatment. After 3 treatments, much of the cancer should be dead, so PSA and ALP should drop quickly.