Tomorrow I have bone scans and CT scans in Las Vegas 110 mile drive. Then I meet with a doctor about Xofigo down the street. at Comprehensive Cancer Centers of Nevada
On Monday, I meet with a doctor in SLC Utah Cancer Specialists about LU 177 aka Pluvicto. Not sure if the two doctors will advocate which direction is best for me. What to do? FYI my PSA has risen from .1 a year ago to now 2.5. I have a met in my L-2 and pelvis. Thank you all for your thoughts. Jim
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Jamesjohn63
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OK. Trying to be clear in my opinion only. Since you have only two known bone metastasis sites. And you do not have bone pain. It seems the Xofigo (Ra223) would not be the priority now. The bone scan and CT will make sure there are not more visible elsewhere.
Pluvicto works better earlier rather than at later stages with more tumor burden. So I would definitely keep that appointment and pursue it if it is offered. You will need to have a PSMA PET scan for that (Pylarify).
Since you are exploring all options you may want to consult with a radiation oncologist about targeted SBRT to those two bone sites in case they don’t respond adequately to the Pluvicto, which could still be of benefit in treating other unseen “micro mets “ as long as they still have PSMA on the cells. (Likely if the others show PSMA expression on the PET scan.)
BTW, “visceral” means any other soft body organs other than bone and lymph nodes, such as liver, kidney and “gut”.
Are you progressing even though your testosterone is in castration level? (Aka castration resistent disease)How many mets in pelvic bone?
With you only have two bone mets, SBRT may be a good option for you as a MDT (metastasis directed therapy). Even though it is more studied in castration sensitive scenario, there are some data in castration resistant disease and may be a smart way to postpone more systemic approach such as Xofigo or LU
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