Pluvicto pain

[Shanelle07]

my father has undergone 3 infusions of Pluvicto. He has psma and fdg completed with no significant discordance.

I understand tumour flare tends to occur within the first week after infusion but he tends to have more discomfort towards the end of the cycle. We aren’t sure if it’s bone pain or muscle pain. His psa started slowly coming down after his 2nd. Is this common or concerning? Also is calcium was somewhat low.. thank you

[Tall_Allen]

Have his doctors tried corticosteroids for the pain?

[Shanelle07 in reply to Tall_Allen]

Yes they only prescribe them first 2 days after infusion. I’m curious if pain can present at later times in treatment due to the treatment or is this cancer pain itself? His scans indicate he should respond well. I’m also curious if the low calcium can cause this discomfort.

[spencoid2 in reply to Shanelle07]

My pain is greatly reduced after pluvicto but increased randomly at unexpected times. First it went up after the first treatment within a few days. Then it gradually reduced to the point that I could get by with little morphine and a little NSAID. The next treatment the pain flare occurred after two weeks. The same was true for fatigue. It did not follow the typical pattern. I asked the nuc med team and they said that variation is not unheard of.

Before pluvicto pain in two major lesions had become quite bad. Now after two treatments I only need a little morphine at night to kill the relatively minor pain to the point that i can sleep.There are so many things conspiring to keep me awake that I do not need another.

[Miccoman]

For what it's worth, here's my experience:

When I got my second opinion about Pluvicto, from MSK, that MO suggested that I was a candidate for rebound pain. So she worked out a week-long steroid protocol with my RO.

Initially I started with 4 two MG Dexamethasone tablets day of and next day, then 2 a day for three days, then 1 a day for 2 more days. That was too much and I cut it half after the first time. I have no pain or fatigue and the steroid "glow" lasts for several days after. Now, after my 5th Pluvicto I cut it in half again, as I was just too amped up the first day.

I only have one kidney so I can't take NSAIDs and so it's Tylenol and gabapentin for pain -- and that is controlled well right now.

I hope you find the right combination of meds to make things better as each of us has such different reactions (for me opioids don't touch pain, go figure!).

[Leader4077 in reply to Miccoman]

Even though I was diagnosed and started treatment in 2004, cancer pain has only recently been a factor. 1 Tramadol and 2 combo Advil/tylenol is the daily minimum for me…..help s for 6-8 hours. A good day means 1-2 Tramadol.

[j-o-h-n]

Greetings to Shanelle and to her Dear Dad,

Would you please be kind enough to fill in your Dad's bio (age? location? meds? treatment center(s), doctor(s)'s names? treatments? symptoms? and etc?) All info is voluntary but it helps us help him (you) and helps us too. Thank you!!!

Good Luck, Good Health and Good Humor.

j-o-h-n