Psa going up after Pluvicto.

[Cynthgob]

Husband is just finishing his 6th isotope. Psa seems to be going up quickly. Today psa was 7.1. Last test 3 weeks ago was 3.5. 3 weeks before that 1.51. Wondering if as soon as you are off the pluvicto psa spikes. He had to delay isotope due to shortages and then he had covid. Thoughts?

[Tall_Allen]

Isn't he scheduled for a PSMA PET scan? You may want to ask for an FDG PET too the following day (he has to have fasted before an FDG PET)

[Cynthgob in reply to Tall_Allen]

I don’t believe it’s a psma scan. The same ct scans he’s been having yearly.

[Janhpr in reply to Cynthgob]

My husband had a CT Scan showed only small progression but PSA rising. Referred for a PSMA PET Scan and showed widespread bone mets with avid PSMA. Had 3 rd Lutetium 177 this week and PSA down from 10.8 now 5.8 hopefully going in the right direction

[Cynthgob in reply to Janhpr]

Yes husband had psma scans before pluvicto. But no’s psma scans after treatment. I think because it would only be a curiosity rather than a change in treatment. No isotopes are being offered after 6 so what would be the point?

[MateoBeach]

PSMA and also FDG PET scans are needed to consider possible further Lu treatments. CT is not specific enough. But it appears that he not accruing more benefit from the Pluvicto now. Perhaps time to switch it out to another systemic treatment.

[Cynthgob in reply to MateoBeach]

When I asked about the possibility of getting more than six isotopes the dr said they won’t be giving more than 6 due to the fact they need to fulfill the promises they made to other patients . Novartis may be open to the idea but not until they make isotopes more available .

[Willofthewisp in reply to Cynthgob]

Germany offering higher dose