PSA/Pluvicto Concern

[spencoid2]

I am having last of 6 Pluvicto treatments tomorrow. I could not wait to have blood work so had it done today on the way to SF.

last PSA was 560.6 about 3 weeks ago and today is 1221.88 using the exact dates the doubling time in months is .76 months. I know there can be a PSA spike with various treatments but I also concurrently have increasing bone pain to the point of making walking difficult without taking a lot more morphine than I want to. I especially do not want to mask the pain and do something stupid like fall and have another pathological fracture.

I also had a an xgeva injections recently and have had increased pain and extreme pain on urination. This is also "under control" with morphine.

Doctors are not terribly concerned and are supposedly good ones. Am I missing something, are they?

I am getting a referral for a palliative care doctor who hopefully can manage my pain without making me feel like a criminal.

There was some mention of immunotherapy and some possible trials but nothing concrete or followed through on.

I was hoping for lead 212 but do not seem t be getting replies from the manager of the one trial available in the US.

I want to be optimistic but this is getting more and more difficult. I spent 2 months largely in a wheelchair due to last pathological fracture (it was a fall and might have not really been pathological but my opinion is that since there is a lot of cancer in the area that it was) I am not ure I can stand any more time crippled like this especially if no one cares about managing my pain.

Idea? My doctors are supposedly the best including UCSF Dr. Aggarwal and Dr Hope.

[Tinkudi]

Prayers for you to be guided to whatever is best for you 🙏🏻🤗

[Tall_Allen]

Radiation kills canecr cells. They release PSA into the serum.

[spencoid2 in reply to Tall_Allen]

but the pluvicto was 6 weeks ago. Shouldn’t blood level have stabilized by now. The pluvicto does it killing for about a week not 6. And then the previous spa rest was shortly after a pluvicto treatment when level would have been high if caused by cell death. The timing just seems wrong. Psa doubled in less than a month from an already high level

[MJCA]

I am surprised that you were given the sixth cycle of Pluvicto. After my fifth cycle, my PSA went from 303 to 465. I was also scheduled for a PSMA-PET, they stopped Pluvicto at that point. I’m in the South Bay, receiving treatment at Stanford.

[VisorF9]

You are resilient and brave spencoid2. Yes, side effects can make us question efficacy and value of treatments. If doctors are not concerned, or don't appear to be, perhaps clear the air with them? Share your feelings. Our docs are our lifelines, after all. Prayers for you.

[Miccoman]

I am amazed that acupuncture has greatly reduced bone pain in my pelvis. YMMV, of course, but doctors generally do not even consider it. Look for an integrative oncology center, they may offer a few treatments for free (mine gives 4 -- and I'll be paying out of pocket for more).

Good luck on getting into the lead clinical trial!