Recurring prostate cancer individual seeking Letetium 177 before it spreads more
My recent PSMA scan evidenced recurring prostate cancer now in seminal vesticule following proton therapy in 2015. Well respected USA hospital MD said surgery & radiation out due to previous proton radiation & closeness to bladder & rectum. Other than ADT only hope would be to get Letetium 177 treatment to keep cancer from further leaving seminal vesticule.
Any advice would be appreciated
Get a second opinion from an expert in high dose rate (HDR) brachytherapy. Only HDR brachytherapy can treat the seminal vesicles.
Per Memorial Sloan Kittering, Vanderbilt, & The West Cancer Clinic, I am not a candidate for HDR brachytherapy as my seminal vesicles butt right up against my rectum and bladder. It would be like dropping a stone in the water to hit the target, but the ongoing surrounding waves would wreck havoc on my bladder & rectum in a way that would not be desirable. Thank u very much for your response though.
I had hole gland proton radiation, does that not treat the seminal vesicles?
For primary treatment, seminal vesicles are usually treated with radiation only in high risk patients. The OP was asking about salvage treatment, not primary treatment, If HDR brachy couldn't be used for salvage, protons wouldn't be a viable option either.
Since the cancer is hormone sensitive and apparently is not metastatic, I would look for Lu 177 PSMA therapy abroad, probable in Vienna or India.
Greetings Will,
Would you please be kind enough to tell us your bio. Age? Location? When Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?
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Good Luck, Good Health and Good Humor.
j-o-h-n Thursday 06/16/2022 11:47 PM DST
I think their is a shortage of Lu177 although I am not sure. You must have to take a second opinion. Suggesting Dr Sen ishitasen from FMRI India. Talk to her. She is available at dr.ishitasen@nuclearmedicinetherapy.in
Lu177 PSMA has been used in hormone-sensitive prostate cancer with small volume metastatic disease (less than 10 sites of metastases) with favorable results. Although not a standard of care intervention, recent data shows that lu177 allowed patients to defer ADT and maintain a good quality of life. Attaching the link of a recently published article
doi.org/10.3389/fnume.2022....
Points to be considered against Lu177 PSMA therapy are the salivary gland toxicity and the risk of bone marrow suppression
Prostate cancer spread to pelvic and lymph nodes 
Prostate Cancer Therapy:
PSA Increase from 11.7 to 34.8 in 2018. Two Axumin scans negative for recurring prostate cancer.
Prostate cancer uses fat to spread and resist medications
Why keep prostate after cancer has spread?
Husband had similar problem but before any radiotherapy to prostate - he had one infusion ac225 and one infusion lu 177 and this reduced the cancer sufficiently for them to have enough of a margin to radiate the prostate. He went to Docrates in Finland.