ON 4TH INFUSION OF 177Lu-PSMA-I&T & H... - Advanced Prostate...

Advanced Prostate Cancer

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

john4803 profile image
21 Replies

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?

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21 Replies
Shams_Vjean profile image
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 profile image
john4803 in reply toShams_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 profile image
Shams_Vjean in reply tojohn4803

Appreciate the info. Thanks!

Tall_Allen profile image
Tall_Allen

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

john4803 profile image
john4803 in reply toTall_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 profile image
Tall_Allen in reply tojohn4803

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 profile image
john4803 in reply toTall_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 profile image
john4803 in reply tojohn4803

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

Seasid profile image
Seasid in reply tojohn4803

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

SViking profile image
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 profile image
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 profile image
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 profile image
Seasid in reply toChewiemo

Are you on any bone medication?

Chewiemo profile image
Chewiemo in reply toSeasid

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

Seasid profile image
Seasid in reply toChewiemo

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

Chewiemo profile image
Chewiemo in reply toSeasid

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

Seasid profile image
Seasid in reply toChewiemo

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 profile image
Chewiemo in reply toSeasid

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 profile image
Seasid in reply toChewiemo

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 profile image
Chewiemo in reply toSeasid

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

Seasid profile image
Seasid

Could you share in which clinical trial you participate?

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