Hopefully my husband will start Radium 223 in 4-6 weeks. He recently stopped abiraterone after 5 months as his PSA was doubling every month. While he was on abiraterone he was taking 2mgs of dexamethasone, although 1mg for the last month. He’s currently taking 6mgs of prednisilone but our question is does he need to be steroid free before he can have radium 223? I think it’s going to be difficult to achieve this in only 5-6 weeks as he’s had withdrawal issues going from dexamethasone to prednisilone! He can ask the radiologist when he sees him for an initial consultation in 2 weeks time but we wanted to know before then in order to plan his withdrawal.
Thanks
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NLondon43
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Thanks for your reply. Yes he has been on ADT since diagnosis. He’s not scanned that often, he had a PSMA body scan anout 6 months ago but the feedback we’ve had has been very vague, we’ve just been told there is widespread bone disease, some lymph node involvement but no visceral tumours. We’ve been told that this scan can’t be compared to the previous MRI to plot differences!
He doesn't have to get off steroids before taking Xofigo. But why was he taking so much dexamethasone? The normal dose of steroids for a castration-resistant man taking abiraterone is 10 mg prednisolone (5 mg twice daily) or 0.5 mg dexamethasone once a day.
Thanks for your response, that is good news as it means he doesn’t have 4 weeks to get off the steroids completely. He was on 0.5mgs for the first month on Abi, but when his PSA doubled the oncologist put him on 1mg, then when a month later his PSA doubled again he went on 2mgs for 3 months and then because of SE’s back down to 1mg for the last month. As part of his withdrawal he was initially put on 4mgs of pred but had a very bad reaction (terrible bone pain and high temperature) so 3 days later his oncologist increased the pred to 6mgs, this has helped but he’s still struggling. Does a change from dexa to pred, even with the equivalent dosage cause problems which may be adding to his difficulties?
They gave him a lot. Any amount higher than a replacement dose can cause bone loss, weight gain and loss of immune function over time. Usually, doses that high are only given for metastatic inflammation, or temporarily with chemo.
Hi do look at my husband’s profile, started R223 7th December New Cross Hospital Wolverhampton he had Lu six treatments last year initially successful, but PSA rising last 14.4 went down after Lu 1, last CT still bone Mets. NHS won’t fund PSMA PET Scan, advice regarding further Lu it will only give 50% of time had. fatigue is the main side effects of R223 after 1st treatment best wishes Jan
My dads going to be starting this at new cross once his red blood cells increase? His finished chemo in september after 10 rounds, but the bone mets are resitant and PSA going up, and his unavle to walk more than a few yards.
Hi Judwil, 1st R223 7th December a little bone pain but manageable, 2nd R223 10th January OK for the 1st 3, then severe intestinal pain with profuse diarrhoea. He has suffer since RT 2019 with proctitis and the treatment has really woken this up. Also the tinnitus which he sufferers normally became unbearable yesterday. I rang NC said to contact GP. They sent out domiciliary paramedic she did routine checks temp/BP/sats/glucose and abdominal examination, was to get further pain relief for abdominal pain and further treatment for diarrhoea and to prescribe ensure as he isn’t eating and appointment today for PROSTAP overdue, INR and full bloods. Nothing from surgery by 11am so rang then, nothing had been done, have now arranged bloods etc. for Monday. Radiologist NC rang today and would contact GP if done nothing, to ring back later today. It’s NHS DIY these days
Think my husband has been unlucky with R233 because of suffering Proctitis, which is similar to colitis. The infusion is quick in and out. Suffered low Hb for a long time but the Iron infusion he had approx November has raised his Hb 106 hope this helps keep in touch, best wishes Jan & Tony
And so sorry your husband is going through the same as my dad.
My dad who is 73 has got to go to new cross on monday for blood test, to see if his red blood cell count as gone up, it needs to be no lower the 80 for them to carry out his first radium injection.
Im dreading it to be honest, since last June is gone from walking and enjoying life to being in pain, not eating very much now, feeling sick weak and dizzy and struggles to walk a few yards. Chemo seems to have made him worse, plus showing signs of depression.
I hope this radium shrinks the cancer on his spine, without making him too ill.
Hi, can’t they treat your Dads blood levels, do you know what levels they are. Tony feeling better nausea and intestinal pain greatly resolved, GP said could have been a gastro virus, will see after next treatment, next bloods at NC on the 5th February, except for PSA surgery did full bloods on Thursday and seem OK. Tony has been anemic for years because of all the treatment he’s had. Has also suffered Proctitis bowel frequency, bleeding since RT in 2019, waiting appointment for some treatment. had endoscopy /colonoscopy, last year, endoscopy diagnosed Barrett’s disease which explains why he has difficulty in swallowing and was give iron infusion to raise Hb. GP has just prescribed folic acid for 3 months which I think helps with Hb levels. He can’t swallow iron tabs and liquid iron and gummies made his tongue and teeth black. We both celebrated our 80th Birthdays this month, low key celebration lunch with some of the family as Tony gets fatigued quickly. The photo of us was May 2021 nearly 3 years ago, time flies, Tony has been battling this terrible disease and treatments since 2008, instead of enjoying a healthy retirement. best wishes to you and your Dad, Jan & Tony
Glad Tony is feeling better.
My dads consultant is phoning him Wednesday to discuss his condition, hopefully prescribe something to help his low blood count.
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