Can anyone share their experience with Pluvicto?

After Xtandi no longer worked and after my husband's first Pluvicto, his PSA rose to over 1,300. In a telemed appointment this morning, the nuclear medicine specialist suggested we consider hospice. I was shocked. A second Pluvicto treatment is scheduled in two weeks, and neither my husband nor I are ready to give up. He is often tired and his legs are weak, but he gets up every morning, comes down a flight of stairs and eats breakfast. Watches a lot of tv, plays his guitars and spends his days like many retired people do. I think we should at least wait until we're sure Pluvicto isn't reducing the cancer at all before giving up treatment other than pain meds. He doesn't need a hospital bed and/or visiting nurse. What do you other cancer patients think?

Doing Pluvicto A second or third time is not unusual. In Australia, it has become more common. You should ask about the possibility of having it a second time. I’m surprised that they pulled you off chemo after two different tries and the PSA not dropping below 13. I’ve heard that from many people, but when they continue with it, it does work for some of the people. I know people have had their PSA rise after having a second or third chemo session, Only to have a drop After later sessions.

Ask your doctor about it, Would it make sense to try it again?

My Chemo was deemed to have failed after 2 treatments of stagnate 13 PSA and I was allowed Pluvicto 12/2023. My PSA was halved with my next test. PSA dropped with each test after finally reaching 0.11-0.15 for the next months until 12/2024 when it began to increase. December was 1.05 followed by March 4.01. Pluvicto was a respite for me, I got to be myself again for 1 year or so. Side affects were minimal during the 6 treatments and for me was a blessing. Now I'm seeking another treatment plan, Oncologist appointment today. I was diagnosed in 2016 and am 74 now.

Appreciate your response. We have a telemed visit with the Director of Nuclear Medicine (who oversees the Pluvicto treatments) scheduled for Monday, 4/1, but I may suggest to my husband that he also contact his oncologist. Thanks again for your input.

I know of other people who have had spikes in their PSA while on Pluvicto. Usually by the 3rd session the results will improve. Pluvicto works very well with 1/3 of patients OK with 1/3 of patients and not at all with 1/3 of patients. Some people have to stop because it doesn’t work or the side effects are too strong. It is probably worth at least 2 more session, but you should speak to your doctor and see what he/she has to say. I have never heard of the PSA going that high so that concerns me and I’m not a doctor.

As a follow-up, my husband's PSA on Monday (3 weeks after first Pluvicto) spiked 300% in 3 months to over 1,000. Wondering if others have had similar results and hoping the PSA will be reduced after continued treatment.

Morning. 79 years young and just had my first Pluvicto treatment last Friday, 21st. Been through chemo, targeted radiation, ADT and I also have Pulmonary Fibrosis. Cancer has spread to my bones and PSA is up minimally. I had virtually no side effects from Pluvicto so far, other than a little dry mouth. That said, I have not had much energy taking Zytiga and Lupron injections for 18 months, and Pluvicto may have added to that 'tiredness,' its a judgment call. Hardest part was walking around the house and staying 3 feet away from my wife, and not touching things. Today we can hug!!! She's been a rock and made this as 'easy' as possible for me. Personally, I think we have to 'choose life,' and do what we can to prolong it........but I am not in pain, thankfully.

Hi Colleen @colleenyoung. Thank you for your concern in response to my first posting. My husband has lab tests tomorrow and second Pluvicto treatment in a few weeks. Taking Gabapentin and/or Tramadol for leg and back pain. He has good and bad days battling the fatigue and pain. He does eat well but exercise other than walking short distances is impossible. He is 82 and this is hard. I have been reading other patients’ comments and find them helpful.

This is @smc24. Regarding fatigue during Pluvicto treatments:
I've had 10 to-date, 6 in the original clinical trial and now repeating the 6 after the USFDA approval with Medicare.
My best response is to get some extra rest, BUT stay as active as possible and eat well. My go to is chicken noodle soup and plain mashed potatoes for a couple of days after each treatment. For me, keeping my system moving helps get the drugs and radiation out more rapidly and, I just feel better, allowing me to look forward to each day. This is my two cents on the subject based on a lot of experience.

Hi Kathy @ksc47, I believe members @glendagomezhidalgo @smc24 @lag have mentioned fatigue and weakness related to Pluvicto and can share their tips and experiences. How is your husband doing? Has he had further treatments?