Danger of radiation to others while r... - Advanced Prostate...

Advanced Prostate Cancer

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Danger of radiation to others while receiving Pluvicto

shipoo profile image
27 Replies

I received my first dose of Pluvicto on 8/31. Upon discharge I was advised to quarantine for 3 days and to sleep in a separate bedroom and use a separate bathroom for those 3 days. I was told to drink a lot of water so as to wash out the radioactive material injected into me. I also got a baseline of radioactivity in my home prior to my treatment which was about 20 counts per minute (CPM) Immediately after my treatment the Geiger counter read 13000+ CPM. After 3 days it had dropped to 3000+ CPM and after 15days the CPM at 3 feet is about 30CPM. 50 CPM or less is considered safe.

I have never seen any research to prove the 3 day quarantine is sufficient to insure the safety of others and I am concerned that the high CPM that my body is emitting after the 3 day period creates a risk to those I come in contact with.

Neither my oncologist, the radiology dept. at my medical center, nor the manufacturer of Pluvicto can offer any information beyond the suggested 3 day quarantine although none can point me to research that shows this to be sufficient.

Any guidance, suggestions, or information would be greatly appreciated. I am very concerned that I can be of danger to others while my CPM remain high, despite the guidance given me.

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shipoo
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27 Replies
Shooter1 profile image
Shooter1

I haven't had Pluvicto, but while on Xofigo (Ra-223) I stayed away from young grandkids for 2 weeks. I was advised that one week would be enough but I figured 2 might be better... Kind of interesting to watch Geiger count to up as it approaches you... best of luck.

TeleGuy profile image
TeleGuy

You brought this up a couple of months ago and I had done the same experiment. And I got the same result as you: 10-14 days before your radiation is similar to the background.

Here’s what I wrote before:

My view on this is more conservative than anybody probably. I go out of my way to minimize exposing my loved ones to the radiation I emit and it really doesn't take much effort. Remember that you excrete something like 75% of the radiation in the first day, but if you get the VISION trial amount of 7.4 GBq, that's still 1.8 billion emissions per second on day two. I had my treatments in Germany where their laws say that you can't go out in public until you are emitting less than 23 microsieverts, which is why they quarantine you for a couple of days.

When I came home during the shutdown, I was supposed to quarantine anyway, so I also measured my radiation with a Geiger counter to see when I felt it was safe to be near others. I slept in the guest room until my readings were double the background radiation at a distance of two feet. (The background radiation is what you would read if you set out the Geiger counter and just let it measure the radiation coming in from the cosmos and also emanating from radioactive material in the earth). I typically got doses of 8-9 GBq and it took 10-14 days until I was at that point.

TeleGuy profile image
TeleGuy

I want one!

MateoBeach profile image
MateoBeach

First of all, most of the Lutetium isotope is eliminated from the body via the kidneys and urine within the first few days. So the urine is radioactive with the Lutetium. Advisable to use a separate bathroom / toilet for three days and flush twice wiping up any drips to also flush.

The residual radiation that is detected by the Geiger counters or sensors as in the airport are not detecting the high energy Beta particles from Lutetium decay. They can travel only very short distances in the body (a few cells) so do not get out of the body. What are being detected are incidental photons that are co-released along with the beta decay.

What I was advised out of an abundance of caution was to not have sustained close personal body contact, such as sharing a bed, with another for 3 days. And especially with a child or pregnant woman.

shipoo profile image
shipoo in reply toMateoBeach

thank you for this reply. I am trying to ascertain how the precautions suggested and how it was determined that the radioactivity that can endanger others is eliminated from the body after about 3 days. Can you direct me to any studies that made these determinations. I keep hearing them repeated, but am unsure how these suggestions came into being.

Thanks

TeleGuy profile image
TeleGuy in reply toMateoBeach

The math on this, however is that if you excrete, say 70% in the first few days, and you got 7.4 GBq, you still have billions of decays per second going on... so a large percentage decrease in a huge number is still a huge number.

You da Renaissance man!

nobaday profile image
nobaday

any idea what the CPM numbercidctgatcwill set off airport alarmed.

When Chernobyl went off what was the CPM…. 30,000000??

Where and how much for your Geiger counter?

And then the next question. Will the excess radiation cause cancers to other parts of YOUR body. Obviously no absolute answer to this except possible and quicker you pee away the radiation the better. As I said to someone else, stay away from children, pregnant women…. And small dogs!!!

Carlosbach profile image
Carlosbach

Maybe not a nurd, just a 22 Kaliber (small bore) 😉.

Actually, I'm intrigued by your hobbies. Pretty damn interesting stuff!

erjlg3 profile image
erjlg3

Awesome what you did but sorry what happened Kaliber!

Kaliber profile image
Kaliber in reply toerjlg3

chit happens … 😂😂😂

Carlosbach profile image
Carlosbach

Once I was picked third for a b-ball game at the Y

Carlosbach profile image
Carlosbach

that’s some cool shit. Major respect

Kaliber profile image
Kaliber in reply toCarlosbach

❤️❤️❤️

TeleGuy profile image
TeleGuy in reply toKaliber

Hey, I was about to reply to your post and the photo of your cool nuke lab but did you delete it, I don't see it!

I wonder if the pancake tube might be the better thing for what I was doing. I was able to amuse myself by placing the Geiger counter over different parts of my body, and when it was over the lymph nodes that we were aiming for, it really did show a big increase in radiation. I used my hand as a control, and was concerned at how much radiation was being detected there. I had a long chat with a physicist in the radiation oncology department and he thought that I was probably getting emissions coming sideways through the tube and not so much coming directly from my hand.

Kaliber profile image
Kaliber in reply toTeleGuy

definitely a pancake detector is far more sensitive ( than a pickle probe ) and does all 4 kinds of radiation. Tho pretty expensive, the Inspector ( shirt pocket ) pancake probe dosimeter has been all the rage over time. There are many interesting YouTube videos on pancake and scintillating dosimeters to help you make a decision.

I have the Atom Fast scintillating dosimeter and it’s only supposed to detect gamma and X-rays, but an alpha emitting smoke detector button overloads it at several feet. I suspect from daughter isotopes , because alpha radiation is supposedly limited to 1/2 inch in open air and unable to penetrate a sheet of paper, thin plastic or dead human surface skin.

Modern detectors that work with smart phone apps offer wide ranges of handy exposure calculations , alarms and storage of measurements.

😁😁😁

I just saw on Amazon , a more affordable , pancake dosimeter ( $418 ) the GMC GQ-GMC 600 dosimeter, looks to be loaded with features too. Just fyi.

Kaliber profile image
Kaliber in reply toTeleGuy

an interesting story directly related to this thread : when I serviced and aligned the imaging heads for the full body nuclear scanners at the local V.A. Medical Center ( I worked there 22 years and retired from there ) , the lead tech in the nuclear department was a bit lax with his isotope generator handling protocols ( things were a bit more dangerously relaxed back in the early 80s ) . While aligning the heads, oftentimes I could see a pair of forearms and attached hands swinging down the hall outside the department, thru 12” cement block walls. He was as hot as a firecracker. He transferred and I don’t know what ultimately happened to him, but he’s probably dead by now and hard telling how many people he exposed. Weird … scary

TeleGuy profile image
TeleGuy in reply toKaliber

Ahh, so that's your background. Nice that you have a lab at home. My last bone scan, the tech was bragging about how they can go twice as fast now with their new, more sensitive, gamma camera. I said: "I don't want fast, I want less radiation!" So I talked him into giving me half the Tc dose and running the scanner at the normal speed. He actually called Siemens to get the correct settings. I thought that was really nice!

Kaliber profile image
Kaliber in reply toTeleGuy

in your records you should see a ctdi and dlp radiation dose statement. Plus, if used , a contrast agent statement. Without going thru a course in radiology here, these are readings of total exposure related per slice and lengthways head to toe + scatter in the room usually collected by a film badge they pin on you during the scan. They represent mGy’s ( grey scale ) of radiation. You can probably look this stuff up on the web for more detail. It’s for both ionized and nonionized radiation. That and remember I was a servicing engineer and not a doctor. I had to ensure beam calibration and timing … I was never associated with exposing actual patients to radiation, tho I was often behind the shields when it was done ( doctors not getting the fine film results they want can become very testy yayahahahaya )

Having said that …. if a machine is twice as fast, that could mean it’s delivering half the mGy to get the same results … meaning they can run you thru twice as fast. Since I don’t actually know the context, this could also speak of computer speed and / or computer performance plus sensor detail ability. It’s quite complicated . In all respects, I would think “ twice as fast “ would mean half the total exposure by some means.

Always …in the industry, it’s always been about reducing the total mGy and get finer more contrasting detail ( obtained in numerous ways , including , sensor improvements, and contrast injections ). There have always been industry standards about how much radiation patients and techs can receive over a period of time ( usually one year ) and in totality. Notice that the doc and techs always wear a film badge to measure their exposure.

Disclaimer: I retired in around 2006 ( something like that ) after 32 years , total, military and V.A. civilian service. That was nearly two decades ago. Much has changed in that interim and I could have forgotten a lot. Back in my day, bone scans were usually accomplished by passing your body over a hot source under the table, and a detector head above the table was most often used. That machine required my attention. They probably used RIAA contrast injections too but they had two full body heads they used for everything, I maintained those heads to specs. I wasn’t on the medical side. I’d hope that there are far more efficient and detailed methods developed since I’ve retired. Lol

CAMPSOUPS profile image
CAMPSOUPS in reply toKaliber

Yea. I have an image in my head that's creepier than any sci-fi, horror movie I've seen from your experience.

"12 inch cement walls". My first time getting scanned although my overall knowledge of radiation was/is minimal I put 2 and 2 together when I realized I was in the lowest bowels of the hospital basement getting my scans.

Kind of like the nuke weapons storage on the aircraft carrier I once was on. Entry guarded by marine and way down in the bottom of the ship.. Air conditioning was phenomenal lol. Made me want to be a weapons specialist.

Carlosbach profile image
Carlosbach

Funny Stuff😆

We've basically had the same sports experiences except I grew up in northern California.

My Little League coach once asked me to not show up to an important game in my uniform (since the league rule was that all "dressed" players had to play in the game).

Then, in 7th grade the b-ball coach asked me to try out for the team. I was pretty proud of being recruited (especially since I was short and fat). It wasn't until later that I got clued into his strategy. The coach wanted 10 players on the team for practice. There were only 11 boys in the 7th grade and the other 10 all tried out. Unfortunately, one of the boys was legally blind, so I got romanced into joining the squad.

Fightinghard profile image
Fightinghard in reply toCarlosbach

Carlos

Great story. Still laughing 😂 lol 😂

my experience is almost as good…. Back when I joined the Marines, my marching was mostly 2 left feet, so the Captan had me transferred to Camp Lejune. I was usually thirsty.

You know the rest of the story…..so im here now!!!

Carlosbach profile image
Carlosbach in reply toFightinghard

By the time most guys get our age their recollections are sometimes muddled. I've met a lot of guys who were 4 year starters in every sport and would have went pro if not for some odd misfotune or injustice. Or, they got transfered because the captain was jealous of their success with the ladies.

But you, me and Kaliber would have fun on the bench.

PS - hopefully you were drinking booze, and not the water

erjlg3 profile image
erjlg3 in reply toFightinghard

😥😥😥

Carlosbach profile image
Carlosbach in reply toerjlg3

You're welcome to join us on the bench. I would have been a 4 year starter on the furthest end of the bench from the coach, but i broke my finger in a shootaround

CAMPSOUPS profile image
CAMPSOUPS

Although nite and day difference in terms of the product my installations of printing press converting lines probably similar as far as the customer relationship, the expectations, the what was left out, all those "company business things".

Most domestic customers were 230/240 volt with the occasional 440. Overseas 380 and 440.

I once blew a servo drive 440 volt. Was a field install on existing press. Final checks including schematic, add one assumption lol, power up and boom "hope that was the air cylinder on the carton stacker cycling but I guess not. I just blew the drive".

Anyway, a small nugget of my working days. Mainly wanted to throw in my story of blowing up the 440 drive ha.

Yes glad to not have to live up to the expectations of customers, to be the face of the company when the metal meets the street especially in the corporate companies.

Kaliber profile image
Kaliber in reply toCAMPSOUPS

the good thing is that neither of us have to do that anymore yayahahahaya tho I might trade to get rid of my cancer 😂😂😂😂

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