I completed six Pluvicto treatments in December 2023 and returned to Mayo in Rochester on January 31, 2024 for a Choline Pet scan to see if it would reveal any non-PSMA PCa. My doctor reviewed the report and scans and informed me that my cancer appears to be in complete remission.
The findings of the report follow: ”PROSTATE: There is again mild choline activity seen in the small prostate. No abnormal PSMA uptake however is seen to indicate tumor recurrence. LYMPH NODES: No abnormal choline uptake is seen to indicate pelvic node, abdominal nodes, thoracic nodes, or cervical node metastasis. OSSEOUS DISEASE: No abnormal choline uptake is seen within the bones to indicate bone metastasis. No change from the previous scan. OTHER METASTATIC DISEASE: None.” My PSA continues to be undetectable.
I will return to Mayo every three months and alternate PSMA and Choline scans. We will take action as needed (could be targeted radiation, for example) when my PCa reappears. I will continue, for now, Lupron and Nubeqa. Since Pluvicto appeared to be my last and best hope to push my PCa back, I feel extremely grateful about these results.
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Skifanatic
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That’s a great result. Congratulations. You don’t mention it but before you began Pluvicto, did you have PSMA and FDG scans to ensure the ratio was right for treatment?
Prior to Pluvicto treatments I had PSMA scans to show the avidity of my tumors, which was quite high. It steadily diminished in the PSMA scans taken after treatments 3 and 5.
I was really fortunate. No side effects that I could tell. With chemo it was minimal as well, just a day of total fatigue. But with Pluvicto, nothing. And my blood labs stayed in the normal range. I realize how lucky I’ve been since I’ve read so many other cases of bad side effects.
So quick question. Sorry if I missed it, but did you do Chemo prior to Pluvicto? I just did first treatment of Pluvicto end of January and did not do Chemo.
I get confused as well, so you’re not alone! Here’s how I understand it and there are others who can explain this far better… Most prostate cancer (PCa) cells carry a Prostate Specific Membrane Antigen (PSMA) protein and the level of PSMA is referred to by an SUV score or its avidity. The higher the SUV, the brighter the PSMA presents on the cancer cells, and the more likely they are to be targeted by Lutetium-177, or Pluvicto. However, there can be multiple type of PCa and some won’t have the PSMA protein and won’t show up on a PSMA Pet Scan. Six weeks after all the treatments have been concluded, Mayo does a Choline-11 Pet Scan to see if there is more PCa beyond the PSMA-type that the Pluvicto has been radiating and, hopefully, killing. There are other types of Pet Scan, such as FDG, which are also used. There seem to be some professional differences of opinion about the relative effectiveness of Choline versus FDG. I have discussed this issue with my doctor and he believes that Choline is the best way for us to see any non-PSMA cancer after the Pluvicto treatment. Hope that’s helpful, and I hope others will correct any mistakes I may have made in my description!
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