PSA in lower range, yet PSMA PET SCAN shows diffuse bone Metastasis

[Ij2023]

Dear all , my father latest Total PSA level shows 6.24 which is down after touching 10.45. He was given one infusion of Docetaxel, however, he has been weaned off due to adverse reactions he has had, as his overall condition worsened and he had lot of prolonged mouth sores, with WBCs touching .08 and besides, he just could not sustain the after effects and was similar to in an ICU like condition. He has also been put on Denosumab, and given the second shot few days back. How is condition is like, in terms of survival , prognosis and what else can we consider, as he is not fit for chemotherapy. His PSMA pet- scan findings were quite diffuse bone metastasis and it is showing in the Skelton and skull areas with lymph nodes in the deep belly, however, the organs are not affected. He is also showing encephalopathy like weird, disoriented talks. His sodium levels are constantly lower at 126 mg for last few years, on which the physician thought it could be due to that. He is already a post liver transplant patient and compromised on the immunity front as he is on Cyclosporine, though its a minimal dose as he is into 22nd years since liver Tx. I request for your help please.. thanks !!!

[Tall_Allen]

Talk to his oncologist about cranial radiation. Also discuss Pluvicto.

[Ij2023 in reply to Tall_Allen]

Thanks Sir

[tango65]

Sorry about his situation.

If the cancer has multiple bone metastases and diffuse infiltration of the bone marrow associated with leukopenia, (and I assume anemia), IMO it is contraindicated to do radiotherapy, external or internal using Pluvicto or any other beta particle emitter.

You could consider looking at the clinical trials with Protacs or at clinical trials with immunotherapies.

The MO could help with the protac trials, There are several ( ARV 110, ARV 766, ONCT 534 etc. )

Dr Dorff at City of hope could help you with immunotherapy treatments

cityofhope.org/tanya-dorff

This is one of the trials

clinicaltrials.gov/study/NC...

[Nfler]

Maxone posted earlier, You might want to try this as it seems to work better than Pluvicto and hits difficult metastasis…

healthunlocked.com/redirect...