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Pain Flares Post Pluvicto Injection

Posted by soflada @soflada, Jul 16, 2025

Been through the first 3 Pluvicto injections. The initial treatments have not given problems but between 3 and 5 days following treatment I've had severe "flare ups." Each time has been in a different body part but they are similar in that each has had excruciating pain controlled only by substantially increasing the Oxycodone that I'm taking. Have other Pluvicto patients had similar situations? I'm especially interested in hearing from patients who have moved to #4, 5 or 6--should I expect a similar problem with them?

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Colleen Young, Connect Director | @colleenyoung | Dec 12, 2025
In reply to @sdaniel43 "He passed away early this morning. Sepsis took over his body and he had no fight..." + (show)
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He passed away early this morning. Sepsis took over his body and he had no fight left in him.

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@sdaniel43, I'm so sorry to hear about your loss. Sending you a gentle embrace.

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jimw77 | @jimw77 | Dec 13, 2025
In reply to @jtr495705 "@sdaniel43 Had my first injection of Plu 10/15/25. Finished Taxotere on 6/17/25. Rough road. Dropped PSA..." + (show)
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@sdaniel43
Had my first injection of Plu 10/15/25. Finished Taxotere on 6/17/25. Rough road. Dropped PSA from 12.3 down to 3.7. Increased to 4.5 in a month so we decided try Pluvicto. Positive margins on excised pieces on 2/13/12. Mostly hormone therapy since then until scan on 2/5/25 revealed 6 lesions on my liver.
I noticed intermittent pain in my lower back and right shoulder a week or so after my initial injection of Pluvicto. Got worse over the next month, some days difficult to walk for a while. Dr. said he had not had many reports of that issue. I went to a chiropractor and he saw that the illeums were probably rubbing and some interference between S1 and L5.

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@jtr495705

I had my 3rd Pluicto treatment earlier this month. After #2 and #3, I've had intense pain in a shoulder into the neck, and also my lower back for a few days. It comes on suddenly and then after a few days seems to just as suddenly let up. It doesn't seem directly related to my bone mets or to my general old-man arthritis and deterioration. (I'm pushing 78 with lots of co-morbidities.) So my suspicion is that the pain flares are the Pluvicto working, killing cancer cells, causing inflammation which sensitizes nerves. Other side effects have been manageable. My PSA after treatment #1 went from 17 to 22, but dropped to 6 after the second treatment, so it does look positive.

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stup1dwaz | @stup1dwaz | Dec 13, 2025

I've had all 6 treatments, mets were in the lymph nodes. PSA went from 8 to undetectable. Dry mouth for the most part after each injection. However after the 6th treatment, dry mouth, lymphedema in the legs, some minor back pain, platelet and RBC dropped like crazy. I get new bloodwork done in January, hope values improve. PSMA-PET scan doesn't show any cancer. BTW I'm 83.

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Colleen Young, Connect Director | @colleenyoung | Dec 13, 2025
In reply to @sdaniel43 "Thank you Colleen." + (show)
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Thank you Colleen.

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@sdaniel43, I can imagine that you are dealing with many things at the moment. I just want to let you know that there is a support group on Mayo Clinic Connect that is there for you when you want or need to talk with others:
- Loss & Grief support group https://connect.mayoclinic.org/group/loss-grief/

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