Stage 4 bone metastasis failed pluvicto MCRPC what options do I have?

What I am about to say sounds crazy from this world’s perspective, however, I think you have touched upon hope when you said, ”…nothing seems to work.” In my way of thinking, everything you have tried has been on one side of the ledger…fight and destroy the cancerous life that is within you. Rarely (if ever), do we accept and forgive the cancer like we might do to unwelcome and desperate strangers who have come to your house in search of a friendly meal. Rarely, (if ever) do we accept that it is precisely “nothing” that works. What this might mean for you is to accept it as part of yourself and acknowledge that it is exactly like you…trying everything to stay alive despite the enormous odds against it. I think cancer has much to teach us, and much wisdom to impart if we can stop shouting “No!” to it for a while. It might look something like a truce or a cessation in the hostilities, but it might present you with a small window of peace and gratitude knowing there are people and things that rely upon you for life.

There is one step past Pluvicto and that is Actinium. It is not approved in the US yet but I know a patient that went to Austria a few months ago to get that treatment. In his case, it was not successful.

Read up on Actinium so you can understand how it works. It is real hard on the salivary glands and can make it very difficult to produce saliva for a while after treatment.

Have they tested for neuroendocrine cancer? The treatment for that is the platinum chemo you were having, that’s why I ask. There are really no treatments available for it yet that are lasting. There are a couple studies going on, but they are not easy to get into.

Maybe you can get an FDG pet scan to see if there are metastasis that do not produce PSMA. That is one of the reasons that Pluvicto doesn’t work. It targets PSMA as does Actinium, without it being produced by some of your metastasis, your treatments would be ineffective.

I wish I could provide more promising ideas.

If you want a number of options presented I would recommend attending one of the Ancan.org weekly Advance prostate cancer meetings. The next meeting is October 8 at 3 PM Pacific time Meetings last two hours and people who are new get to participate first. Another meeting Oct 14 at 5pm pacific time. Get to the meeting in five minutes early so you are the first new person. Sign up at Ancan.org so you can get their weekly newsletter, which always has informative new information.

People running the meetings have up to 15 years of experience, working with people almost daily on advanced prostate cancer issues. There were also two or three doctors in every meeting.

You will be asked to describe what your situation is and treatments you’ve had and they will try and suggest solutions that will work for you.

Thank you for the recommendation