Radium 223 Xofigo Treatment

[Islandboy2021]

I have considerable pain in my hips and tale bone 3 days after first injection of Xofigo. The Radiologists mentioned I could get pain flare a few days after the injection. Is there anyone familiar with Radium 223 side effects.

[Kentucky1]

I did all 6 doses of Xofigo from June 2022 through December 2022. I didn't have a pain flare like you describe but it has affected both my hemoglobin and hematocrit levels. Both have went down to well under normal range and still remain there. I also experienced a jump in PSA that remains elevated . These side effects are attributed to Xofigo affect on the bone marrow cells. From what I have found in the literature it can take up to a year or longer for things to return to normal. I've had 2 infusions of packed blood cells and one iron infusion. Currently taking iron supplement daily.

[Tall_Allen]

That is correct. Radiation causes inflammation, which may result in temporary pain. NSAIDs should help, or a Medrol dose pack if it doesn't.

[tango65]

This is information from the FDA

accessdata.fda.gov/drugsatf...

[Mcrpca]

My husband will have his 4th dose next week. Side effects have been minimal so far. Bone pain about the same. Blood counts good. PSA up after first dose, no change after the second dose. Follow-up labs before the third dose will be drawn on Thursday. Mid-treatment bone scan tomorrow. I’m told the scan may validate the treatment or not. MO started him on Xgeva with calcium & vit D supplements before starting the Zofigo. I don’t know if that made a difference or not. Sorry you are having side effects.

[Finlay66]

I had the same. I still have muscle and ligament pain after the second injection. The worst of the pain subsides though after the second injection and the good news is my ALP is falling fairly fast. I'm seeing my Oncologist this week to review the next steps but I think it's important to do the whole course.

[3putt]

this is very timely information for me as after 5 years of Zytiga, Lupron and prednisone my PSA has jumped up to .7. Oncologist suggests starting Xofigo. I feel great and seeing the side effects of this treatment has me a little on edge. I’m wondering how high my PSA could go before I should consider this latest suggestion?

[Islandboy2021 in reply to 3putt]

I failed abiraterone after a couple of months. My PSA is climbing and currently at 8.45 before starting Xofigo.

Once this treatment is complete I will start chemotherapy again.

[winkoliu]

I did Radium 223 a few years ago, I had no side effects (everything as usual) but the PSA did not go down.

[3putt in reply to winkoliu]

what’s your treatment protocol now if you don’t mind me asking?

[Islandboy2021]

Continuing Zoladex every three months and recently started monthly Xgeva and Xofigo. Also was able to convince doctors to give me Estrogel.