Pluvicto damaging salivary glands?

[Kayakbob]

Finished 6 rounds of Pluvicto 9-1-23. Now on ADT holiday since 1-1-24, psa unmeasurable so far.

During the treatment, had increasingly serious drymouth and nasal congestion and irritation with bleeding, which I attributed to radiation damage. Since then, there has been some, slow improvement, but still not right yet.

I'm using biotene drymouth lozenges and rinse, they provide some relief. Eating dry foods like baked goods (or even potato chips) requires constantly sipping liquids.

Anyone else experiencing these side effects?

(as I tell everyone...'beats the alternative!')

[Tall_Allen]

There has been some improvement using sialendoscopy. Here are some therapies - none are great.

prostatecancer.news/2021/01...

[Kayakbob in reply to Tall_Allen]

Thanks, TA! I'll check with my ENT re this procedure. Even if I knew this would happen, with no resolution for this, I still would go thru with the Pluvicto treatment.

[NotDFL]

It's well known that the salivary glands are PSMA avid.

[spencoid2]

TA said that permanent Xerostomia is very rare with LU 177 (Pluvicto) but if it happens to you ... And I don't think it is that rare and the damage increases with each treatment. Mine seems to be temporary but i stopped after just three treatments. It is not common but it can be severe to the point that it can interfere with your ability to eat. Xerostomi is one of the most common reasons for discontinuing Pluvicto treatment so the trials are biased in terms of not reporting severe cases. I was constantly asked about dry mouth after and before each treatment so it is known that it can be serious and needs to be dealt with appropriately even if that means stopping Pluvicto treatment.

[Yank66]

Yes, this was a problem for hubby. It has improved, but he had dental issues about 5 months after the final treatment. He lost one tooth and needs crowns now on two others. I wonder if he did not consume enough water after each treatment (yes, he was advised 8 oz of water each hour he was awake). His dentist recommended non alcohol mouthwash and mints for nighttime use.

[dentaltwin]

Generally in cases like this we would prescribe sialogogues (meds stimulating salivation) such as pilocarpine, bethanechol or cevimeline. Ask your dentist or physician if a trial of one of these is warranted.

[Kayakbob in reply to dentaltwin]

Thanks for some specific advice dentaltwin! I'll discuss this with my doctor(s).

[j-o-h-n in reply to dentaltwin]

Again..... the two of you to the rescue!!! Thanks...

Good Luck, Good Health and Good Humor.

j-o-h-n

[Gl448 in reply to dentaltwin]

Are there any potential downside to those drugs?

[dentaltwin in reply to Gl448]

They stimulate the parasympathetic nervous system, so excessive sweating, flushing, some gastrointestinal upset--at least theoretical. I haven't seen it in my patients with normal dosing. They're supposed to be avoided in uncontrolled asthma and glaucoma, uveitis.

[Hope422PC]

My husband did. The doctor told him to suck on sour candies. We tried a few different brands, but the favorite was Icebreakers sour.

His symptoms have improved over time