I’m so discouraged, the nurse just informed me yesterday that my Dad’s PSA is increasing on Lu177 and I don’t think my dad understands that this means it is not working. His current PSA is around 1400.
The treatments are incredibly hard on his body and he has stopped eating Whole foods. He lives off about 3 Ensures a day.
My question is do I have a sit down discussion about what the implications of his rising PSA means and talk about potentionly discontinuing treatment that is so hard on his body so that he may enjoy what time he has left without the nasty side effects of a treatment that is not working?
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I think that conversation should include his oncologist. Whether he can tolerate treatments of some kind depends on his bone marrow status, and his liver and kidney function. I think it's a good idea to get an FDG PET/CT at this point to show if his cancer is largely not PSMA-avid, and also a biopsy of a metastasis. I don't know what therapies he's had and what his medical status is, so I can't comment. But there are probably many therapies in clinical trials. A lot depends on what he wants to do.
TA - I have nothing to contribute, nor is it technically any of my business. That said, I want to thank you for your continued objective, linearly concluded opinions/advice which I find to be valuable. Sometimes others seem to have emotions which understandably cloud their responses to you. I am not immune to emotion , but find your input clear, concise, and of great value to those of us less educated on the intricacies of the chemistry/physics available to fight our common foe.
You say the nurse informed you PSA is increasing on Lu177, but did she also inform you that the oncologist says that means the treatment is failing? My MO told me it was not always clear that a jump in PSA means Lu177 is not working.
Let us know how many treatments and what the PSA has been at each reading so far. Also, what exactly are the symptoms he is experiencing? I had minor fatigue for early sessions, but have become increasingly anemic and fatigued as I proceeded. Since most men have very few side effects from Lu177, knowing exactly HOW (other than loss of appetite) this is impacting your father may be helpful to others.
I am sorry to hear that it is hitting him so hard. Is he anemic, and how severely if so?
Please see a blood doctor ( hematologist) . He may need an infusion and my dad has had many the treatment may not be failing bc it depends on your father's history and his average PSA and what the scans show , not PSA alone .. please read my recent post on a trial my dad is in .
I feel so sorry for your dad and you. The Lu177 therapy is not incredibly hard on the body and the loss of appetite is not caused by the Lu177 therapy. This may be caused by the chemos he received so far and the growing cancer which is indicated by the high PSA value. Some patients see a drop in PSA after the third cycle. I assume he has had cabazitaxel already, otherwise this would be an alternative to Lu177.
Yes. My husband’s PSA was rising even three weeks after second Pluvicto. The day before third treatment it was undetectable! Scans seem slower to show this improvement but will know more in a few weeks.
We never thought for one minute he would have an undetectable PSA.
Dont relay the minimal negative comments from the nurse to him. Need to hear the full story and possibilities of current PSA and symptoms and possible treatments from the Oncologist.
Please give us a summary of his treatment history. Looks like he had a good run on Zytiga and now started Pluvitco rather than a re-challenge of chemo. (his only chemo was at the time of diagnosis it looks like to me?)
If his appetite issue is coming from the cancer then treatment with a re-challenge of chemo may make a difference provided his blood health can handle the chemo.....all IMHO and speculation on my part but possible.
As Tall Allen said a FDG/Pet scan to make sure whether Pluvitco is even indicated for him and blood work to determine if his marrow is capable of supporting him thru other available treatments.
Lutition did not work for me. I switched to actinium and it is working well. I’m on my 4th and last treatment (just received it 10 minutes ago and unlike Lutition it has been very effective in decreasing my PSA with reasonable side effects.
I am not informed like our Tall Allen.... what I do see and feel that your Daddy is very tired. Sometime we need to feel better in our last days.....Let him have his time feeling better just by taking a well deserved holiday from being in front of the battle line. Much pain relieving medication and lots of love will see him along much better than fighting a war that doesn't offer your Daddy any happiness. God Bless you. I can feel the angst and pain you are in. Take the best of care.
first off - God bless you both. My father passed away of prostate cancer in January. We endured a 3 year battle after receiving stage 4 diagnosis. His PSA was around 600. Chemical castration (Lupron). brought it down significantly and we had a good year in there but ultimately PSA rose. He did not want chemo or any other treatments. We looked at Lu 177 but due to COVID treatment out of the question. Sorry it is not working for you. Continue to pray 🙏. Quality of life is crucial. Enjoy every minute you have and don’t dwell on the future. End treatments if it is too hard in my humble opinion.
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