Update on neuroendocerine prostate cancer mets to liver.

[Believeit]

As mentioned previously my husbands prostate cancer has now metastasised to his liver. He also has bone mets. He had 6 cycles of Etoposide and Carboplatin. This combination of chemo worked very well. As we are looking at getting Pluvicto for his bone mets we also organised an FDG scan. (As advised on this forum) This scan showed that the liver mets had totally gone and we were told that Martin “no longer had any cancer in his liver” and was an eligible candidate for Pluvicto.

We met with Martins MO yesterday and while he agrees the cancer is no longer visible he thinks that it is still there and will come back as this is an aggressive form. He is wondering if having pluvicto is wise.

Am just wondering if anyone on the forum have knowledge on this. If the FDG scan shows there is no cancer in the liver is this the case or could there be minuscule amounts. Would Pluvicto be wise to do right now?

Any information would be greatly received. We are just not sure what to do right now but are leaning towards Pluvicto and hoping that the liver mets don't come back. Martin is is asymptomatic and is very healthy otherwise

Wishing everyone joy for the season and a Happy and healthy 2024.

[Tall_Allen]

First, that is amazing that the chemo worked so well!

The cancer in his liver is gone, but is the FDG scan still showing cancer mixed in with his PSMA-avid PCa? When you overlay the two PET scans, are they showing both kinds in the same places? My thinking, and I may be wrong, is the two types of cancer are competing for resources (e.g., blood, lipids, glucose, proteins). Getting rid of the PSMA-avid type may free up resources to feed the neuroendocrine cells, allowing them to proliferate rapidly. The neuroendocrine cells are the more dangerous of the two. This is just my opinion.

But if the FDG scan is completely clear everywhere, maybe Pluvicto will give him more time. It is a tough decision.

Is he eligible for any of the clinical trials?

prostatecancer.news/2016/12...

[Believeit in reply to Tall_Allen]

Thanks for your response Tall_Allen. I really appreciate it.

We will check the scans again but as far as I know the FDG showed nothing in the liver and the only thing that lit up were some nodes in Martins chest which are sacroditis from years ago. It did not show anything in the bone mets.

I did ask the MO about a trial but he said he didn’t know of any for neuroendocrine pc mets. We will talk to him about this again.

We are going to take our time on making the decision on Pluvicto as we were told there is no big rush. We will wait for the next scan in February. Hopefully that will still be clear and we will take it from there.

Thanks again.

[Tall_Allen in reply to Believeit]

The reason I wrote that article was so patients like you could discuss them with your oncologists. Most oncologists won't know about them, so it is your job to bring it to their attention. Ask him specifically about the trials in that article. In fact, email him the article first.

[Believeit in reply to Tall_Allen]

We will definitely do that. Thank you.

[antisocialsocialwrkr]

Hi there, glad he tolerated it well and had great results. My dad’s docs have said the same. Basically the same chemo worked well but within 2 months, it came back even worse throughout the liver. Hate to give you that info. All that to say, I’d remain aggressive whatever you do. My dad just started a clinical trial today at Duke. Getting his second immunotherapy infusion as we speak. Whatever you two decide, my thoughts are with you.

[Believeit in reply to antisocialsocialwrkr]

Thanks for your reply. Hope your dad is doing ok. It is a horrible disease. We will keep trying. 🙏🤞