Does Pluvicto work? What's the prognosis?

Posted by cal77 @cal77, Mar 6 10:03am

Hi,

Docetaxel doesn't seem to be working..My husband's PSA is up now to 500!! He's had 2 treatments of Docetaxel so far, but they are only giving him 1/3 dose, because he had a tumor removed at his spinal cord at T4 in November and is trying to get mobile now.

So, does Pluvicto work? Is it as good as Docetaxel? What is the prognosis with Pluvicto? This is all so scary.

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Profile picture for cal77 @cal77

Hi,They are thinking of trying Pluvicto with my husband. What is the prognosis with this? When I googled it, I read 15 months increased survival! That doesn't sound very good to me..Anyone had Pluvicto? How are you doing?This is all so scary...What about Immunotherapy for Stage 4 Prostate cancer? His PSA is up to 500, although 2 weeks ago it dropped to 490 and didn't increase..so we were thankful for that..Thanks,

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Howdy North of...

Oh, I'm aware of that, thanks...but I find it interestingly scary to advertise that for people that don't have statistical education or training...LOL...no offense to anyone...but I can see how it would freak someone out!!!

I really DO thank you for the support...I meant that my 5 years of treatment has been a series of either no information or ...hmmm...BS...'sorry!...

I prefer to stay on top of things the best I can, read statistics but not necessarily believe them without finding myself in denial...Everybody is different in so many ways...physically, emotionally, psychologically...

Best regards

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Profile picture for northoftheborder @northoftheborder

@deccakid wrote ❝I also have the questions about the info from the manufacturer..."15.3 months vs. 11 months"...What the hell is that supposed to mean??? If I had 11 months to live and my Doc didn't tell me that, I'd be pissed!!!❞

And I'll just repeat that while the median is useful for quantitative comparisons in a time-limited clinical trial, it doesn't tell us much as patients.

Here's a simple (albeit extreme) example: let's say we have 9 patients in the study group in a tiny trial. 4 of them survive 2 months, 1 survives 3 months, 1 survives a year, and 3 survive 10 years.

While the median survival is 3 months, the *mean* survival is nearly 43 months; however, they can't know that at the end of the 4-year trial, because some of the participants are still alive at that point, so they stick with the median, which they do know (once half of the participants are gone).

I'm not saying the gap is usually that big, but when you hear that there's a "median" overall survival of 15.3 months, don't assume you have 15.3 more months to live. That's just not what the number means. It's a scientific convenience, not your personal destiny.

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@northoftheborder

Saw the radiation safety officer yesterday, along with Radiation Dr. and nurses...When I asked how long pluvicto would extend life vs. chemo, he said 4 months! Really?? I don't get it and I don't understand where they get this info from.

Also, regarding safety of Pluvicto. As the spouse, they said my husband could sit in the back seat and we could drive the 20 min. home and that would be find. But, we're not 6 feet apart. I asked if he could take a Taxi Van so he is further away in the back seat, and they said that wasn't allowed because he's not allowed to be in the public where they don't have consent. Also, someone has to wheelchair my husband out to the main door of the hospital and that's another 10 minutes at least. Then we have to go back the next day for another trip to the hospital for a scan, so another 20 minutes back and forth and also close contact with the wheeling of the wheelchair. This all makes me very worried.
Then, we sleep in separate rooms with a wall between us, but only one foot between the end of this feet to the bedroom wall, and then my head is right there on the other side of the wall.
I think I should just stay in a hotel for 2 nights as we don't have a separate bathrooms and my husband has to pee in urinals...so lots of potential for splashing and spilling...OMG ...this all sounds so horrible...
What do other people do? Do they stay in hotels...? or maybe they have larger houses and separate bathrooms and maybe their husbands drive?

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Profile picture for cal77 @cal77

@northoftheborder

Saw the radiation safety officer yesterday, along with Radiation Dr. and nurses...When I asked how long pluvicto would extend life vs. chemo, he said 4 months! Really?? I don't get it and I don't understand where they get this info from.

Also, regarding safety of Pluvicto. As the spouse, they said my husband could sit in the back seat and we could drive the 20 min. home and that would be find. But, we're not 6 feet apart. I asked if he could take a Taxi Van so he is further away in the back seat, and they said that wasn't allowed because he's not allowed to be in the public where they don't have consent. Also, someone has to wheelchair my husband out to the main door of the hospital and that's another 10 minutes at least. Then we have to go back the next day for another trip to the hospital for a scan, so another 20 minutes back and forth and also close contact with the wheeling of the wheelchair. This all makes me very worried.
Then, we sleep in separate rooms with a wall between us, but only one foot between the end of this feet to the bedroom wall, and then my head is right there on the other side of the wall.
I think I should just stay in a hotel for 2 nights as we don't have a separate bathrooms and my husband has to pee in urinals...so lots of potential for splashing and spilling...OMG ...this all sounds so horrible...
What do other people do? Do they stay in hotels...? or maybe they have larger houses and separate bathrooms and maybe their husbands drive?

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@cal77
There is no standard amount of time. Pluvicto works. Four months would be on the Short side.

The guy that runs the Advance prostate cancer online forum for the reluctant brotherhood had his Pluvicto treatment about four months ago. His treatment was so successful that after three treatments, his PSA dropped a .05 and he did not take any more treatments, holding them off till later. His PSA has stayed close to that since the Treatments. He’s had prostate cancer for 12 years and has had almost every treatment you’ve ever heard of.

The biggest problem is that it is not successful for everybody, about 40% of people don’t get good results. The other 60% vary from 50% reduction in PSA to a major reduction in PSA. You need to see what happens to figure out how well it’s going to work for him. Some people get 18 months out of it.

You’re getting a little overworked about the radiation. I know some people that have been told many fewer requirements for keeping apart. You don’t have to worry about it going through a wall.

A 20 minute ride is not enough time for a significant radiation transfer. You could always rent a bigger car for two days, But I bet the doctors will tell you that’s not a problem.

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Profile picture for Jeff Marchi @jeffmarc

@cal77
There is no standard amount of time. Pluvicto works. Four months would be on the Short side.

The guy that runs the Advance prostate cancer online forum for the reluctant brotherhood had his Pluvicto treatment about four months ago. His treatment was so successful that after three treatments, his PSA dropped a .05 and he did not take any more treatments, holding them off till later. His PSA has stayed close to that since the Treatments. He’s had prostate cancer for 12 years and has had almost every treatment you’ve ever heard of.

The biggest problem is that it is not successful for everybody, about 40% of people don’t get good results. The other 60% vary from 50% reduction in PSA to a major reduction in PSA. You need to see what happens to figure out how well it’s going to work for him. Some people get 18 months out of it.

You’re getting a little overworked about the radiation. I know some people that have been told many fewer requirements for keeping apart. You don’t have to worry about it going through a wall.

A 20 minute ride is not enough time for a significant radiation transfer. You could always rent a bigger car for two days, But I bet the doctors will tell you that’s not a problem.

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@jeffmarc Exactly. I haven't had Pluvicto myself, but I think the main thing is just not spending 8 hours in the same bed together. Driving in the car doesn't seem like it should be a problem.

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Profile picture for Jeff Marchi @jeffmarc

@brbriggs
Actually, they zapped them with SBRT radiation. It is quite different from x-rays Which aren’t used for metastasis treatment?

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@jeffmarc
I think SBRT is x-rays, though they're different x-rays from the ones used for imaging.

From Google AI:
Stereotactic Body Radiotherapy (SBRT), also known as Stereotactic Ablative Radiotherapy (SABR), is a noninvasive, external beam photon radiation therapy that delivers highly precise, high-dose radiation to small, localized tumors in 5 or fewer sessions. It uses advanced imaging to target cancer while sparing surrounding healthy tissue.
Mayo Clinic
+4
Key Aspects of SBRT Treatment:
Radiation Type: Primarily uses high-energy X-ray beams (photons) generated by a Linear Accelerator (LINAC) or specialized systems like CyberKnife.
Technique: Delivers extremely accurate, high-dose "fractions" or treatments (often 1–5 sessions) compared to conventional radiation (many weeks).
Types of Machines: Common machines include CyberKnife, TrueBeam, Novalis, and VersaHD.
Common Targets: Used for tumors in the lung, liver, prostate, pancreas, spine, and kidney.
Goal: Ablate (destroy) the tumor, often acting as a noninvasive alternative to surgery for inoperable cases.

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Profile picture for carbcounter @carbcounter

@jeffmarc
I think SBRT is x-rays, though they're different x-rays from the ones used for imaging.

From Google AI:
Stereotactic Body Radiotherapy (SBRT), also known as Stereotactic Ablative Radiotherapy (SABR), is a noninvasive, external beam photon radiation therapy that delivers highly precise, high-dose radiation to small, localized tumors in 5 or fewer sessions. It uses advanced imaging to target cancer while sparing surrounding healthy tissue.
Mayo Clinic
+4
Key Aspects of SBRT Treatment:
Radiation Type: Primarily uses high-energy X-ray beams (photons) generated by a Linear Accelerator (LINAC) or specialized systems like CyberKnife.
Technique: Delivers extremely accurate, high-dose "fractions" or treatments (often 1–5 sessions) compared to conventional radiation (many weeks).
Types of Machines: Common machines include CyberKnife, TrueBeam, Novalis, and VersaHD.
Common Targets: Used for tumors in the lung, liver, prostate, pancreas, spine, and kidney.
Goal: Ablate (destroy) the tumor, often acting as a noninvasive alternative to surgery for inoperable cases.

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@carbcounter
Stereotactic Body Radiation Therapy (SBRT) differs from traditional X-ray radiation (conventional therapy) by delivering extremely precise, high-dose radiation over only 1-5 sessions, compared to weeks of low-dose treatments. Using advanced imaging and targeted beams from multiple angles, SBRT acts as an ablative, noninvasive alternative to surgery, maximizing tumor destruction while sparing surrounding healthy tissue. ® Moffitt

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Profile picture for cal77 @cal77

Hi,They are thinking of trying Pluvicto with my husband. What is the prognosis with this? When I googled it, I read 15 months increased survival! That doesn't sound very good to me..Anyone had Pluvicto? How are you doing?This is all so scary...What about Immunotherapy for Stage 4 Prostate cancer? His PSA is up to 500, although 2 weeks ago it dropped to 490 and didn't increase..so we were thankful for that..Thanks,

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Yes, from a physics PoV, I think, "X-ray" just means any type of photon radiation: it was discovered first, and the "X" was because they initially didn't know what it was. By the time they got to other varieties, like ion or proton radiation, they knew what they were looking at (hence, no "Y-rays" or "Z-rays" 🙂, though they do have alpha, beta, and gamma).

In a medical context, as @jeffmarc mentions, the old term "X-ray" has stuck around just for imaging; for therapeutic uses, they use more specific (and modern) terminology.

Disclaimer: I'm a language nerd, not a science nerd, so I may have gotten some technical details wrong.

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Profile picture for cal77 @cal77

Hi,They are thinking of trying Pluvicto with my husband. What is the prognosis with this? When I googled it, I read 15 months increased survival! That doesn't sound very good to me..Anyone had Pluvicto? How are you doing?This is all so scary...What about Immunotherapy for Stage 4 Prostate cancer? His PSA is up to 500, although 2 weeks ago it dropped to 490 and didn't increase..so we were thankful for that..Thanks,

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Howdy,
I'm starting Pluvicto this coming Tuesday. I have to travel 60 miles for my treatment.
I had concerns also about the radioactivity and being in contact with others. The nurse told me contamination is more-so from bodily fluids: sweat, anything expelled from the mouth by sneezing even breathing, urine (of course), feces.
I've engaged medical transportation and was told to wear a surgical mask, clothing that covers the entire body and and nitrile gloves for that hour travel, and that would be okay.
I've already done all my shopping and will not be in contact with anyone for the prescribed time period after getting home.

Blessings for success!!

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Profile picture for cal77 @cal77

Hi,They are thinking of trying Pluvicto with my husband. What is the prognosis with this? When I googled it, I read 15 months increased survival! That doesn't sound very good to me..Anyone had Pluvicto? How are you doing?This is all so scary...What about Immunotherapy for Stage 4 Prostate cancer? His PSA is up to 500, although 2 weeks ago it dropped to 490 and didn't increase..so we were thankful for that..Thanks,

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Please do not go overboard with worries or preparations to deal with the radiation caused by Pluvicto infusions. And please do not pay attention to posts which say you need to isolate for a week or buy a Geiger counter or not travel together in your own car. My husband had Pluvicto treatments in 2024 at Mayo Rochester, and the instructions we received from the radiation team in that department were for me to avoid my husband's bodily fluids and excretions for three days, and not to have young children or pregnant women get near him for a few days. We were staying in a Rochester hotel and used the same room with two beds until we left for home a day later, and were told that would be fine. We sat at the same table for meals in Rochester immediately after the infusions. We had a long drive home in the same car from MN to IN, and were told that would not be at all dangerous either. So please do not blow the radiation issue out of proportion and cause yourself needless worry and extra work or expense. I hope this helps.

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Profile picture for cal77 @cal77

Hi,They are thinking of trying Pluvicto with my husband. What is the prognosis with this? When I googled it, I read 15 months increased survival! That doesn't sound very good to me..Anyone had Pluvicto? How are you doing?This is all so scary...What about Immunotherapy for Stage 4 Prostate cancer? His PSA is up to 500, although 2 weeks ago it dropped to 490 and didn't increase..so we were thankful for that..Thanks,

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Thanks, and "Nahhh"...I take everything in stride...No need for excessive concerns (NOT worries) except those first 3-5 days. My legitimate concern is for those around me. I am single and have gone through these entire procedures by myself...No biggie, I'm used to it...But I speak out of respect for those that HAVE to be around me...Drivers, store attendants, should I have chosen to shop,...neighbors, my teenage daughter, etc...I mean, why take any chances??
I read everything with a grain of salt and a humorous (yes, I know this is serious stuff, but that's how I keep my sanity!!) outlook...And, since this is my first rodeo with Pluvicto, I'm ever more watchful...
I thank you for your input...how is your husband now, 2 years after?

Blessings

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