Can anyone share their experience with Pluvicto?

@redroadtraveler, you're right that the use of PLUVICTO involves exposure to radioactivity. And I appreciate your diligence after treatment in keeping your distance from others and monitoring your radioactivity.

For all members taking Pluvicto or considering it, please note that it is not necessary to monitor with a dosimeter or geiger counter. With proper attention to instructions from your radiation oncologist you can keep yourself and your loved ones safe.

Read more about what to expect and precautions on Pluvicto's website here https://us.pluvicto.com/about-pluvicto/what-to-expect-when-taking-pluvicto

For more complete details, you can also download the pluvicto_patient_e.pdf Patient Information Insert.

Here's a relevant excerpt

After administration of PLUVICTO
For 2 days after the administration of PLUVICTO, drink plenty of water in order to remain hydrated and to urinate as often as possible to eliminate the radiopharmaceutical product from your body.

Because this medicine is radioactive, you will have to follow the instructions described below to minimize radiation exposure to others unless otherwise instructed by your nuclear medicine doctor.

Contact with others in your household, children, and/or pregnant women
 limit close contact (less than 1 meter) with:
o others in your household for 2 days
o children and pregnant women for 7 days;
 sleep in a separate bedroom from:
o others in your household for 3 days
o children for 7 days
o pregnant women for 15 days;
 avoid sexual activity for 7 days;
 use effective birth control throughout treatment with PLUVICTO and for 14 weeks after your last dose.

Use of toilets
Take special precautions to avoid contamination during the 2 days after treatment.
 You must always sit when using the toilet.
 It is essential that you use toilet paper every time you use the toilet.
 Always wash your hands well after using the toilet.
 Flush all wipes and/or toilet paper down the toilet immediately after use.
 Flush any tissues or any other items that contain bodily waste, such as blood, urine and feces
down the toilet. Items that cannot be flushed down the toilet, such as bandages, must be placed in separate plastic waste disposal bags (according to “Waste disposal recommendations” below).

Showering and laundry
Take a shower every day for at least the first 7 days after treatment. Wash your underwear, pajamas, sheets and any clothes that contain sweat, blood or urine separately from the laundry of others in your household, using a standard washing cycle. You do not need to use bleach and do not need extra rinses.

Waste disposal recommendations
All items to be thrown away should be discarded in a separate plastic waste disposal bag to be used only for this purpose. Keep the plastic waste disposal bags separate from the other household waste and away from children and animals. A member of the hospital staff will tell you how and when to get rid of these waste disposal bags.

Replying for my husband.
We are wondering if you have finished your Provicto treatments and how you did with the outcome. My husband is on round three and has tolerated it other than some diarrhea. His pain has improved. What was your treatment after Provicto?
God bless you.. any person going through this is a champ.

Pluvicto update:

I had my fourth Pluvicto infusion last Wednesday, Today is Saturday, three days after the infusion. As you know if you have been following me on this thread, I have a dosimeter (geiger counter) which I purchased from Amazon for about $100 and use it to monitor my radiation levels. Their generic guidelines tell you to stay three feet away from everyone for three days (a week from small children and pregnant women) and sleep in separate beds for that three day period. If you just follow these generic guidelines you are led to believe that after three days you no longer pose any danger to anyone else (what I call "collateral damage") and it is perfectly safe to resume "normal" life. I disagree. My dosimeter radiation reading at the end of three days is still 1.86. That's maybe half of what it was when I left the treatment center three days ago but, in my opinion, still poses a significant risk to others. They try to minimize the risk, I suppose trying not to scare you in this area that few of us know anything about (but we become knowledgeable out of necessity). They tell you not to worry, that any exposure to others is minimal and can't even begin to manifest any signs or symptoms for twenty years. Well, just think about that for a minute. If you expose your 25 year old grandson or granddaughter to your still ongoing radiation emission you are opening them up for potential problems when they become 45. I choose not to do that. I start by isolating myself not for the three days they tell you is "safe", but rather I isolate myself for a week to begin with, and then allow limited contact for another week.

I will update everyone again at the seven day mark after infusion.

Hope my experience will be helpful to others currently undergoing the Pluvicto treatrment or contemplating doing so. My side effects have been tolerable and manageable. My primary side effect is constipation. That is not the same for everyone and others in this thread have had much worse side effects, so just be cautious and monitor your side effect reactions closely.

@vcash, you may also be interested in these related discussions:
- Anyone on Pluvicto? Looking for a support team
https://connect.mayoclinic.org/discussion/anyone-on-pluvicto/
- Anyone on Pluvicto (Lu 177), a new drug for prostate cancer?
https://connect.mayoclinic.org/discussion/any-one-on-pluvecto-a-relatively-new-drug/
See all Pluvicto discussions here https://connect.mayoclinic.org/group/prostate-cancer/

Hello again. Glad your dad had a good zoom meeting. In my opinion you can never get enough information. As to side effects, you are right to be cautious about them with an 85 year old man in semi-fragile condition. As I have told you, I am 80 years old, have had three Pluvicto infusions and my side effects have been moderate and tolerable BUT everybody has their own condition and reaction. You have heard from others who have had worse reactions and side effects than me. What that says to me is get a dosimeter from Amazon and monitor your dad's radiation level experience and pay close attention to all other side effects he will undergo. He WILL have side effects. It's a matter of monitoring them and figuring out how to deal with them. If they are too bad the doctors may delay subsequent infusions. I send you prayers and wish you and your dad luck on this segment of his journey through life.

Again, please don't worry and assume your dad will have terrible side effects. Everyone is different and even older men can have mild side effects. Your dad's oncologists and their staffs can suggest ways to minimize any side effects that do occur. Hang in there! Sending a hug.

I appreciate your response. Dad had a zoom meeting last week with the doctor from nuclear medicine at Emory in Atlanta. After a consult with his oncologist, he decided to move forward with treatment and is awaiting an appointment. Daddy is becoming frail and has difficulty getting around, though he still manages to mow his lawn, garden, and do some yard work. I am sorry to hear that your pain worsened after treatment. This really concerns me for my dad. I am not sure is he strong enough to endure some of the side effects I have read about from patients. The information I have gotten from the doctors makes the side effects seem less severe than the info from patients. I will update as soon as treatment begins and would like to hear updates from other patients on this Pluvicto journey as well.

eugenelapietra1 What were your symptoms if you don't mind me asking? Have you seen any improvement with the cancer?

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.

Going in to infusion number 4 next week. I think having your own dosimeter (Geiger counter) is very useful for those people who want more direct knowledge and control over what is going on for THEM, rather than simply turning themselves over to the doctor and blindly trusting the overall generic guidelines. But each to his or her own. It's your body. Will keep everyone updated as there seems to be a lot of interest in this thread.