I am a 71 year old and was diagnosed at stage 4 a little over 7 years ago. I found a great oncologist at the Rocky Mountain Cancer Center in Lone Tree, Colorado, who hit the right combination of oral and Lupron treatment right away. I did have external beam radiation on my left femur and spine for areas that were in bad shape and to help prevent fracture. I also had an ablation done to my L3. He also gave me injections of Xgeva to help build bone density My PSAs stayed very low for about 6 years then the cancer went castration resistant.

I switched to the Mayo Clinic for new treatments. I did have the chemo last year and I tolerated it extremely well. Only some minor extra fatigue. PSA went from 50s down to 5.6, considered normal at my age and stage. But PSA quickly shot back up into the 30s and bone pain started. I was approved for Pluvicto at the beginning of the year and have just finished #3. My PSA is not going down as hoped but the Dr thinks it is too early to determine efficacy just yet. I had an an initial uptake scan after the first treatment and it showed good uptake.

My main issue is the bone pain is unrelenting and is much worse for the 3 or so weeks after treatment. Dr said is is an arthritis like reaction to the treatment and I am seeing a palliative care Dr for that. I take light opioids 4-5 times a day and when the pain persists, a light steriod. Since I have only one kidney and it is in stage 2 failure, I am only allowed 10 steroid pills a month so rationing is the key. They work extremely well.

As far as being radioactive, my Dr said in my cse, don't worry too much as the type and strength would not cause problems for healthy adults and pets for 20 years. I just have to limit exposure to children and pregnant women for the first 3 days.

I hope this rounds out what you are hearing and gives you a little more perspective.