My husband Scott (age 70, stage IV prostate cancer, widespread bone mets) had a PET scan a couple of weeks ago to see if his Pluvucto treatment is having the desired effect. His results were mixed, with some mets doing a bit better, some worse, and a couple of new ones since the last scan.
A new and rather worrisome finding was this: "There are multiple low-density lesions in the liver which are new compared to the prior exam, concerning for metastases. However, they are not significantly radiotracer avid above background activity levels."
We have an appointment to talk about these findings with his prostate doc in mid May (unfortunately the only appointment they had). In the meantime I wanted to ask if anyone has had liver lesions show up on a scan that were not cancerous? The doc said if he does have cancer in his liver they will immediately take him off the Pluvicto and put him on chemo. There was no talk of what his life expectancy might be in that case, and online research revealed very depressing statistics.
Is there hope that he might be okay, or is he reaching the end of his fight? Thank you.
If there was radiology progression of the cancer with new visceral metastases, Lu 177 PSMA is not working.
Consider to discuss having a biopsy of the liver mets to do histological, IHC and genomic studies. The cancer may be susceptible to drugs such as olaparib, rucaparib, keytruda, combination of drugs and to chemo with cabazitaxel plus platinum compounds.
Once the biopsy is done, consider to discuss starting chemo with platinum compounds, and trying to get a second opinion.
I would consult with Dr Beltran at the Dana Farber in Boston or with Dr Aggarwal at UCSF
You are 100% right TA. Exactly the scan combination I had at MSK as well as a biopsy of a positive supraclavicular node where they were able to do histology, IHC, and genomic testing (via the MSK impact study)
Fighting the same thing with the liver lesions, went through 6 moths of jevanta, first shrinking but then growing so they stopped it, really kicked my butt. Did a biopsy and found normal prostate cancer cells not the small cell ones which I guess is a sliver of good news. Referred me to MSK, sent the history and insurance but no appointment yet. Will be starting another round of chemo with a different compound. They have sent for a geometric tests, still waiting on that. He wanted to do plivicto trial I could qualify for but once they start the chemo then I do not qualify so who knows how this will, end. The good news is that the FDA has approved the facility in New Jersey for production of the drug for the US and planning on building 2 more sites.
As far as longevity is concerned regarding your Dear Husband Scott is concerned, he will be around for a very long time. Many of us went through the same anxiety that both of you are experiencing until we realized there are new and better meds being developed each day which will prolong a long life together. So start saving up for all the good times you will have in the future but always remember you're the boss.......he's the horse......
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Advanced prostate cancer-gleason 9 with lupron
Bad News. Would appreciate input. 
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Would Carboplatin help with liver mets that are not neuroendocrine?
