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Prostate Cancer | Last Active: 1 day ago | Replies (30)
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I am a stage 4 guy. 4.6 years on this journey. Diagnosis 11/20, Became resistant in July 2023 starting a slow upward trajectory PSA which brings us to now. My PSA is at 12.4. Interesting twist. My oncologist put me on Pluvicto January. PSA continued its slow pace upward. Whoops, last month my PSA jumped from 7.5 to 12.4 and just like that oncologist viewed we decided to stop/paise Pluvicto and right to Xtandi. Yikes, current plan is one more Pluvicto shot, PSA still rising we stop. Either way we set the appointment to go to the big Cancer Research Center and start searching trials.
My boats not sinking, its navigating heavy seas. All journeys in life deal with heavy seas now and then.
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Your experience with Pluvicto is not unusual.
It works really well in 1/3 of cases OK in 1/3 of cases and not at all in 1/3 of cases.
It is not uncommon for the PSA to rise until the third or fourth session, It may go down it may not.
If you are on Xtandi You should also be taking ADT, You don’t mention that. Even if castrate resistant ADT does help because not all of your cancer is castrate resistant. Good to hear you were going to another place for treatment advice, They should never have let your PSA get so high, sounds like You should’ve been on an ARSI like Xtandi before Pluvicto.
If the side effects of Xtandi (Enzalutamide) are too much, you should ask your doctor to switch you to Nubeqa (Darolutamide). It works the same, but has a lot fewer side effects.
One important thing to do before Pluvicto Is to get a somatic genetic test. That’s because some genetic changes that occur due to your cancer can either make Pluvicto worse or better.
Pluvicto genetic issues
RB1, PTen, TP53 are Pluvicto resistant
ATM & BRCA work better with Pluvicto
This is assuming you’ve already had a hereditary, genetic test, If not, I can tell you where to get one done for free.