Six cycles of Lu-177 treatment

[Janhpr]

Hi all

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

FINDINGS:

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

[Finlay66]

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

[Janhpr in reply to Finlay66]

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

[Finlay66 in reply to Janhpr]

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.

[Janhpr in reply to Finlay66]

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

[Tall_Allen]

Congratulations on the excellent response!

[Janhpr in reply to Tall_Allen]

Many thanks, hope the right decisions not to have further Lutetium 177 at the moment, I hope it will give my husband’s body time to physically/mentally recover, without the worry stress and anxiety with each treatment and waiting for PSMA PET scan results; hopefully time to spend happier times.

[tallguy2]

great news! Thanks for sharing!

[Janhpr in reply to tallguy2]

thanks tallguy2 , having PSA on the 15th February and every 2 weeks, has INR done regularly (pulmonary embolism side affect of chemo) so will have done at the same time, will be a telling time

[Poowater]

I hope there's a long remission.

[Janhpr in reply to Poowater]

thanks keeping our fingers crossed

[spw1]

That sounds like a very good response. Good luck for the cruise and sunshine.

[Janhpr]

hoping it lasts a while, planning for the cruise and sunshine but getting travel insurance has it’s difficulties

[Hidden]

Very interested to hear from someone in uk who has had this treaty

My husband is about to have scans to see if suitable

He has had every other treatment

We are going to the London clinic

Self funded

Scans £5k treatment £12k a round so best part of £80k but we are using our rainy day funds

We live in Scotland

My husband is 67

Diagnosed at 59

I have found it very difficult to get information on this treatment and costs so that’s why I am putting it out there

So glad you had a good result

Enjoy your holiday

[Janhpr in reply to Hidden]

Hi we also had to dig deep to pay for treatment, we also looked at the London Clinic and eventually spoke to Simon Hughes, who indicated that there might be help from Novartis regarding fees, but Tony had already started treatment at Genesis, fees at Genesis are £13000 per treatment and £2500 per PSMA PET Scan, they provided a taxi to and from home inclusive in the fees, best wishes to both of you, keep in touch, I post also on Prostate Cancer community UK

[anony2020 in reply to Janhpr]

You might find less expensive high quality treatment in Asia. But of course you have to discount the travel and living costs.

[Hidden in reply to Janhpr]

thank you

For your reply

I’ll keep in touch

Best Sue