Today FDA approval alas. LU 177

[Costarica1961]

Long over due, today it was annouced the FDA approved Lu 177. I was fortunate enough to get it early on along with many others choosing different Routes. I can possibly answer some questions based on my experience. Onward and upward

[GeorgeGlass]

What do you know about what cause GreatJohn's death? He said that the LU177 caused his blood levels to drop in levels that he couldn't recover from. He said that happens to 10% of men who get 177. I presume his doctor told him that. Is there any side effect data to show if this is accurate or not? 10% is very high for something that has a good chance of killing someone.

Did you go overseas for your treatment(s)?

[CurrentSEO in reply to GeorgeGlass]

George,

My guess would be, that GreatJohn had serious cancer penetration in his bone marrow and discordant FDG and PSMA avid cancer.

[GeorgeGlass in reply to CurrentSEO]

That seems like a logical conclusion. If someone didn't have those issues then the percentage rate of this happening might be closer to 1-2% instead of 10%.

[Cooolone]

Link?

[CurrentSEO]

Hi,

Did you check your PSA results after 1st Lu-177?

Did your pain subside?

I just did yesterday a second Lu-177 , I had some serious pain 2 weeks after first Lu for a week or so in my cancerous lymph nodes in pelvic area. PSA dropped 3 weeks after first infusion from 50 (taken 1 week before first infusion and with PSADT around 28 days) to 40.

Next 3rd Lu in 4 weeks, 10 days before it will have 3 months Lupron shot, then 6 weeks after 3rd Lu-177 FDG and PSMA PET/CT to chart next step. Fingers crossed 🤞🏻

[j-o-h-n in reply to CurrentSEO]

Does it count if I keep my fingers crossed for you?

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/25/2022 7:48 PM DST - Greek Independence Day.

[CurrentSEO in reply to j-o-h-n]

It does 😉🤞🏻

[Costarica1961 in reply to j-o-h-n]

Hopefully your legs and Toes as well

[Brysonal in reply to CurrentSEO]

Hope the pain has subsided. I don't have lymph node involvement but i believe Lu-177 works well on those. and Chemo for me today with recommendation for Vmat rapidarc radiotherapy in 20 fractions and HDR Brachtherapy 2 times (Brachy boost) as I've never had radiation other than Lu-177 to the prostate. Subject to post chemo scans. I felt the reasoning made sense. I need to check out the side effects though.

[CurrentSEO in reply to Brysonal]

Pain indeed subsided and currently I do not fill it, thank you. PSA one week before first Lu-177 was 50 and PSADT 29 days, so I assume on the day of first infusion it was around 62. Two days before second Lu-177 it was 35, so I'm happy about it, I'm not on ADT now. Will do Lupron 3 months shot 10 days before 3rd infusion to increase PSMA.

I would check in your place PSA prior to 3rd Chemo and if PSA stays the same or raised after two first Chemo infusions in comparison to what it was before 1st Chemo infusion I would not go ahead with 3rd Chemo infusion and re-evaluate next step, just my opinion of course. However I wish that your PSA keep dropping to undetectable!

Concerning radiation to prostate and Brachy boost, that is individual decision as I might be wrong, but I think chances of impotence with radiation in 2 years (I mean even if you use Viagra) is more than 50% and with Brachy boost probably more. Many other side effects to consider. Also not sure how Brachy boost is useful in metastatic cancer at all.

However if you decide to go ahead with it, think about shrinking your prostate as much as possible using ADT and Avodart (let say for 6 months) and then go ahead with radiation. Look at Carbon Ion radiation therapy offered by MedAustron in Austria and by Heidelberg in Germany. I may consider radiation to may prostate at some point too and if I do most likely will consider Carbon Ion.

Basically do investigate and understand risks vs benefits as some treatments cannot be undone. Maybe radiation to prostate is reasonable, Brachy boost is overboard I think.

Decisions are not easy...

[Justfor_ in reply to CurrentSEO]

The head RO at MedAustron claims that carbon ion scores better against the tough cells that proton or photon may miss.

[CurrentSEO in reply to Justfor_]

Interesting, thank you.

[Justfor_ in reply to CurrentSEO]

For better clarity, I am quoting the exact passage:

"In the case of a PSMA-avid local disease I would propose a hypo-fractionated carbon ion therapy in 16 fractions (4 per week) because of the higher radiobiological value of carbon. For the case the PSMA-PET would not show uptake in prostate region nor detect pelvic/distant metastases I would propose local proton therapy. The total dose is a bit dependent on the individual PSMA-situation which we do not know yet."

They seem top notch there.

[j-o-h-n]

Eyes of course......

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 03/26/2022 7:03 PM DST

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About time! 👏🏼👏🏼👏🏼👍