Pain after Pluvicto infusion

[Oct18]

First I'd like to thank everyone on this site who provides advice and help for all of us asking questions. So here is my next one: I just had my 2nd Pluvicto infusion and my hip and upper femur (where there is active cancer and 6 months removed from my hip surgery I have posted about before) have almost unbearable pain. Has anyone had an increase in pain as a reaction from the Pluvicto? If so, how long did it last? My cancer is in the bones as of September, no soft tissue and no lymph nodes.

My PSA at the start Oct. 9th was 14.7

Nov. 18th PSA was 14.3 (checked locally before Xgeva shot and Lupron.)

Nov. 20th PSA was 15.79 checked at Duke before infusion.

I've been taking Tylenol and or Ibuprofen for the pain prior to my 2nd infusion. The Dr. called in Oxycontin for the pain which I will try at night. A year ago I was running, lifting and exercising even during Chemo so this has been a long year. I am on a trial which does not allow steroids but if that may help, I will just opt out of the trail. I'm only getting the Pluvicto anyway, and not the study drug. Any shared experiences would be appreciated.

[spencoid2]

My bone pain increases after pluvicto. I think it is a known side effect. It can get pretty bad at times.

One thing I want to mention that was explained to me but I forgot who said it. This only applies if you are taking abiraterone which is possible since pluvicto is being given to still castrate sensitive patients. You do not seem to have a profile so I can not tell if you are castrate sensitive and taking aberaterone.

I was taking oxycontin for pain while I was still castrate sensitive and was taking abiraterone. It seems that codeine itself is not analgesic, rather that it metabolizes into morphine which actually is what reduces the pain. Apparently among other things aberaterone prevents this from happening. This is what chat said after first saying no and then changing it "mind"

Your doctor's observation is correct: abiraterone can interfere with the metabolism of codeine. Abiraterone inhibits the enzyme CYP2D6, which is responsible for converting codeine into its active form, morphine. This inhibition can lead to reduced effectiveness of codeine for pain relief.