How much targeted radiation to mets?

[jersy]

Hi, Warriors. I've been through Zytiga, Pluvicto and Xtandi - all failed. Have aggressive metastatic cancer and mets head to toe. Starting to get pain in bones and already had one major blast of radiation to ribs. Can they keep blasting spots as they get painful, or is there a radiation limit? I've already had a lot of radiation from Pluvicto and I heard there is a lifetime limit they won't exceed.

Thanks!

[vintage42]

Can you add a complete history in your bio? Was your prostate radiated?

[jersy in reply to vintage42]

thanks, but history is not needed to answer this - I'm just asking if there is a lifetime limit on spot radiation to mets. My history is in my profile. thanks!

[vintage42 in reply to jersy]

Where is the profile?

[jersy in reply to vintage42]

this is what I wrote 5 years ago. Maybe I did not put it in the right place:

Diagnosed Stage IV, Age 75, Gleason=9 (4+5 in all 12 cores), PSA=130, lymphs nodes positive, distant mets in ribs, spine, pelvis. Started Androgen Deprivation Therapy (Lupron), then chemo or Zytiga. No symptoms except ED and urinary flow issues, and otherwise good health. Top oncologist says "very aggressive".

I have since been through Pluvicto - 6 treatments that ultimatley failed, and Xtandi that also failed. I've had spot radiation to ribs. thanks. I'm now 80 and should add that mets everywhere. Having pain in spine.

[vintage42 in reply to jersy]

So on diagnosis you did not have radiation to prostate or nodes, used ADT for five years, and recently had spot radiation to ribs. Normally you can keep having palliative spot radiations. Your question is whether your systemic radio ligand treatments with Pluvicto would change that.

[jersy in reply to vintage42]

Yes. Does the total radiation I've had (pluvicto plus some spot radiation) limit more spot radiation, or can I just keep beating back the cancer as spots flare up? If I can just keep it at bay with spot radiation, can I go indefinitely like this? The doctor keeps stressing that the spot radiation is "palliative only", so I think he is saying that this is not buying me time - - just less pain.

[vintage42 in reply to jersy]

I think the concern is about over-radiating tissues. You have not had any radiation to the prostate or pelvis. Spot radiation is to discrete places. And Pluvicto only affects individual cancer cells. So I think you can have all the spot radiation you need. Palliative just means not curative -- by diminishing the bone mets it will both buy you time and reduce pain.

[ArchimedesTex]

When I asked the same question at MD Anderson, the radiation oncologist told me that it depends on where the met is located and how much previous radiation you have had to the area previously. Radiation around vital organs such as ribs, spine and pelvis is more limited. In addition, if you already have reduced function to a vital organ from other conditions such as a previous heart attack, they have to take that into account as well. That’s why your individual history is important.

[PHnerd]

My father is in the exact same position as you but much younger (64). He finished Lu-177 and 6 weeks after his final dose his cancer spread to his spine and rib. He’s done so much radiation and his body really took a hit with the docetaxel so I have no idea what the next steps are for him. I’m really devastated.

[jersy in reply to PHnerd]

I'm sorry. It is particularly hard at such a young age.