ON 4TH INFUSION OF 177Lu-PSMA-I&T & HAVE EXPERIENCED "BURNING" BACK PAIN?

[john4803]

I am on my 4th infusion (4 of 4) and PSA of 2.0 dropped to 0.1 after the 3rd. Waiting on labs after the 4th. I am in the Eclipse Trial at the "Center of Excellence" Nuclear Medical Facility at St. Louis University.

After the 3rd started to experience 'burning-like" back pain, at times. Was not sure if it was just the result of a previous, still healing, "soft tissue" injury but now after the 4th am wondering if it is the 117Lu? Pretty well controlled with Ibuprofen.

Any other 177Lu patients have similar results?

[Shams_Vjean]

So glad to hear about the great PSA response in the trial. Congrats on that! Hope the burning sensation resolves quickly.

Do you have a Rad Onc at SLU for this Trial? Mind sharing their name? Thanks.

[john4803 in reply to Shams_Vjean]

I'm being treated by Nuclear Medicine Doc's. I was formerly treated with IMRT & Cyberknife at the sister facility (part of the SSM system), by Dr. Bedwinek, Radiation Oncologist.

[Shams_Vjean in reply to john4803]

Appreciate the info. Thanks!

[Tall_Allen]

How is your kidney function? eGFR? Creatinine? Liver enzymes?

[john4803 in reply to Tall_Allen]

eGFR = 69 mL/min/1.73 m2, Creatinine = 1.11 mg/dL & Liver enzymes - ALT = 18 U/L, AST = 17 U/L.

[Tall_Allen in reply to john4803]

eGFR is low -kidney damage from 177Lu-PSMA-I&T? That can occur if your tumor load is low relative to the radioactive dose. Discuss with the lead investigator before taking another dose. Are doses adjusted for tumor load?

[john4803 in reply to Tall_Allen]

No, doses are not adjusted. This was my 4th and last dose per the trial. Will see if it improves/gets worse with the next labs? They felt the labs were good to proceed to the 4th infusion.

[john4803 in reply to john4803]

These lab's are after the 3rd infusion. I will receive labs after the 4th, in 2 weeks.

[Seasid in reply to john4803]

I believe my kidney function is similar to yours. Everything above 60 is good for elderly.

[SViking]

glad to hear that your PSA has dropped. Will you continue with ADT? I am also on eclipse Trail. About to receive my third injection next week. A month ago my PSA had dropped from 3.3 to .58.

[john4803]

Sounds great! Per a Dr. Kwon YouTube video he says a drop at least 50% after the 2nd injection shows success. I dropped from 2.0 to 0.3 after 2 rounds.

I think my MO will recommend continuing on Lupron but will not see him for a another couple of months.

[Chewiemo]

I had thoracic pain after first dose that resolved then moderate low back pain after fifth dose. My doc opined that shrinking tumors were no longer supporting vertebra. In thoracic area I had compression fracture. Both areas of pain resolved as bone healed as shown by bone scan.

[Seasid in reply to Chewiemo]

Are you on any bone medication?

[Chewiemo in reply to Seasid]

No bone meds. Not even taking calcium. Lifting weight without problems.

[Seasid in reply to Chewiemo]

Whats about the compression fracture? Did you have a DEXA scan? Are you osteoporothic?

[Chewiemo in reply to Seasid]

Compression fracture shown on second bone scan . Third bone scan shows healing. No osteoporosis. No DEXA scan.

[Seasid in reply to Chewiemo]

If you didn't have a DEXA scan how could you know that you don't have osteoporosis? A baseline scan would be good even if your bone density is fine. For me my bone density is the biggest problem now 5 years on ADT.

[Chewiemo in reply to Seasid]

I’ve only been on ADT 8 months. Blood work is good. Bone scans show bone healing and dr. Sees no evidence of osteoporosis. Dr says compression fracture at T11 matched location of tumor and was supporting vertebra. When tumor shrank that caused fracture which is healing and causes no pain.

[Seasid in reply to Chewiemo]

I totally agree that you should not be on bone strengthening medication while you are still in a HSPC phase in order to allow your Mets to heal.

I am not 100% sure in this and I am not a doctor to be sure, but I believe that your bone Mets would probably stop healing ones you start prolia or something similar. That is the main reason that for people with bone Mets it is not recommended to be on bone strengthening medication while they are in a HSPC phase of their cancer.

The only thing you should really do is to ha a baseline DEXA scan.

I am just curious on which blood test are you relying to show you that you are fine and not yet osteoporotic? Could you disclose these tests?

If you have time could you fill out your profile? otherwise it is not possible to say anything more certain without asking you too many questions. I also wish to understand your situation as I am still in a HSPC phase but now osteoporotic.

[Chewiemo in reply to Seasid]

Im not sure what blood work. They test dozens of things weekly for clinical trial I’m in. My calcium is normal.

[Seasid]

Could you share in which clinical trial you participate?