My husband 79yrs old diagnosed in 2008 had a PSMA PET scan 21st December 2021 and it showed he had widespread PSMA avid bony metastases.
PET CT Ga68 PSMA 24th Jan 2023 4 weeks after 6th treatment of Lu177
Comparison is made with the previous PSMA PET scan of 9th September 2022
The scan demonstrates a significant incremental response to treatment. The previously noted ill-defined increased tracer uptake in the left lobe of the Prostate gland has mostly resolved. There remain no discrete PSMA avid pelvic nodes. There are no suspicious PSMA avid retro peritoneal or other extra pelvic nodal lesions. The previously noted scattered PSMA avid bony metastases have either completely or significantly reduced in size and PSMA avidity. For example, the biggest bony lesion in T9 has current SUV max 5.6 versus previous SUV max 13.9. There are no suspicious new PSMA avid bony lesions. There remain no suspicious PSMA avid pulmonary or liver lesions. No other suspicious new avid lesions elsewhere.
CONCLUSION: The scan demonstrates a very good incremental partial response to treatment. PSA reduction from 3.0 on 9th September 2022 and to date PSA 1.31.
All his blood results are normal except Hb 102 raised ESR 64, lymphocytes 0.93. It has been discussed about have further Lu 177 treatments but after discussion decided to have a break from treatment, particularly because of fatigue and dry mouth and difficulty in swallowing and time to improve mobility. The side effects are still much better than when he had chemotherapy but he is 12 years older so this makes a difference. The standard treatment offered before Lu 177 was R223 or further chemotherapy which nearly killed him the last time.
It has been agreed that he has PSA bloods 2 weekly, naturally concerned how long Lu will control the disease and still wonder if should have carried on with further treatment of Lutetium.
Hope this helps others to decide on a way forward and welcome any comments
Hi this is really interesting and of course good news. Can I ask where you had the treatment and was it self funded or through insurance. Thanks
Hi treatment has been self funding at Genesis Cancer Care Windsor, considered R223 rather than chemotherapy again because of the devastating side effects in 2010., but decided time not on our side and with consultants advice opted for Lu. Abiraterone gave 6 years, but became toxic to the Liver. Will have more Lu when and if necessary. We also post on the Prostate Uk community which keeps us in touch what is available in UK. Still hoping that NICE come to an agreement with Novartis re Lu so it is available on the NHS
Thanks. My Oncologist has suggested I'm referred for this treatment at the Royal Marsden as I have multiple bone mets. Docetaxel has not really made a difference and Enzalutamide failed. Please keep me posted on progress. Perhaps this treatment could give at least another 2 years? A Nice agreement would be great news although I'm not particularly hopeful given the price.
Where do you live, let us know how you get on at the RM, have you considered R223. 2 years would be amazing we are both 79 years young hope to go on cruise in May, some sunshine and somebody to look after us best wishes Jan & Tony