Hi- I have posted before concerning my brother’s prostate treatment. To give a brief overview- my brother was diagnosed in March 2021. He responded well to Abiraterone for 18 months. Once his PSA starting trending upwards he was put on several sessions of Docetaxel. Unfortunately at this time, he did not received Lupron as he should have. By this time his PSA was up to 67. As soon as he received the Lupron, it dropped to 26. His oncologist wanted him to take a break to see if he could get strong enough for Pluvicto. He put him back on Abiraterone which did not work at all. After 3 weeks his PSA is 151. I am not happy with the oncologist but with an HMO you are limited. Now his oncologist wants him to do Pluvicto and if not then do Cabizataxel.
Are there other options we should look into? I do not think he is strong enough to do Pluvicto since it is in the sacrum area and he is in quite a bit of pain and is not able to drive himself. I’m not sure he could take more chemo but he needs to start something soon. A question about Pluvicto- how does a person get the treatment if they can’t drive themselves? I was told they could not be near anyone for 6 days.
Many thanks in advance!
Teresa
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TerryR123
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I am just going to answer your last question. We are scheduled for our first Lutetium treatment in mid-February. The infusion will take place at the Cancer Agency which is 100 kms west of where we live. Since I can’t drive my wife will drive us home but I have to sit in the back seat on the passenger side. When we get home, I must sleep downstairs for four days where there we have a guest bedroom and bathroom.Good luck!
Exposure to radiation is certainly a risk but I am sure you can figure out a way to be driven. There are several considerations regarding exposure of nearby people.
To put my suggestions in perspective please note that I am undergoing Pluvicto treatment and have both listened carefully to and read the guidelines and understand the reasons for them.
Exposure is of most concern to children because they likely have a long life ahead of them and the effect of exposure to the radiation from Pluvicto is likely to cause health issues cause by mutation far in the future, 20 to 30 years. This is of concern to individuals who will likely be alive that far in the future. Also radiation exposure can be of more significance to rapidly growing cells of which a young person is likely to have more. Also of great concern to pregnant women and to men who are planning on having children.
For others such as older people the concern is less. Also take in to account other factors that influence how long an exposed person is likely to live.
I was told to not worry about exposing my dogs because the possible effects are beyond the expected lifetime of dogs. Still I am not cuddling with my dogs closely while my emission is high.
The radiation decreases with distance time since the isotope was made and duration of exposure. The exposure level decreases as the square of the distance from the source. And the level decreases t one half for each "half life" period. I believe that the half life of LU 177 is about 6.7 days. So considering half life and distance, the risk even fairly close becomes minimal in a week or two. I was measured right after infusion at one meter. This is not a safe distance for long term exposure at a level of about 5500 counts per hour( they gave me this figure because my Geiger counter is marked in counts. At a distance of 6 feet this level would be approximately 1/4.
If you are taking a long drive and need to be close right after treatment you are justified in being concerned. If the drive is short and if you can get a reasonable distance away there is less concern. IF a very long drive you might want to hire a limo or van so as to be farther from the driver.
My husband is as old as I am and will probably not be alive in 30 years so we are not terribly concerned but do make it a point to stay as far as practical.
You can buy inexpensive radiation detectors from various online sources including Electronics Goldmine. Do not depend on cheaper meters without comparing the indication to an instrument of known calibration. I compared the reading of mine immediately upon arriving home and test myself daily so I will know when it is safe to sleep close to the dogs and not be concerned about being close to people. The decline in radiation is very predictable so a radiation detector is really not that important if you follow the guidelines given to you after treatment but I like measuring things.
You are also told to be careful with urine as it has high levels of radiation for an extended time since that is how your body excretes the LU 177. Be careful to not pee outside of the toilet. Pee sitting down and flush twice. I have to use catheters fairly often so I am careful about how I use them and rinse them thoroughly and dispose in a waste basket that others do not use. I also check them, the toilet and the floor with my Geiger counter.
Right after treatment I did go shopping but made it a point to stay 6 feet away from anyone and if I were to encounter a child I would make the distance even greater and of course casual exposure in public is likely to be of very short duration to any individual.
You are most likely to be emitting radiation from your kidneys bladder, cheeks and areas with PSMA avid cancer. If you absolutely have to travel for an extended period near someone else you might consider a lead apron. You can probably borrow one from your dentist especially since they rarely use them anymore since xray exposure levels are a fraction of what they used to be in the old film days.
My husband has not had any tx similar to what you described. So, I am afraid I am of no help but I will keep him in my prayers for better health and recovery.
Wow! That sounds like some heavy duty stuff. Wasn't aware of that type of treatment. If it's offered to me this time around I'll know something about it. I took a break from here for a good while. Things change pretty rapidly.
My son is still taking generic Zytiga prednisone and Lupron and will be checked at the end of the month so thus far no other treatments except radiation last March. So no extra knowledge here but sending hugs and prayers for you. Please keep us all posted on how you are doing.
My son went in for his three month PSA check up today and it came back the same as three months ago so it’s remaining low. He didn’t mention testosterone I don’t know. I felt like he was being a bit devious, but I hope I’m wrong.
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