This treatment is exciting. The medics and technicians can see more or less precisely where the medicine has gone. That to me is amazing. So how is it done? On Day 1, as I reported in my first blog, I was given my first dose of 177Lu-PSMA-617 - a radioactive medicine that targets and attacks prostate cancer molecules. Unpicking that, the fluid which was pumped into my arm comprises a tracer that attaches to a Prostate Specific Membrane Antigen plus the radioactive medicine that starts to attack the cell and hopefully kill it off. I am now radioactive for seven days and carry a card to prove it. There are lots of dos and donts resulting from this new state for me. But more of that later. On Day 2 the medics wasted no time while I am radioactive to take detailed images of what radioactivity I am emitting and from where. I spent nearly two hours trussed up like a chicken in a special scanner. The results were than compared with those taken pre-treatment to check where the cancers cells were in my body. They had a match. That procedure will be repeated the day after each six-weekly treatment. The results will show how successful or not the treatment has been.
I am still wrestling with the idea of why me when this treatment is still on trial in the UK. From my chats with my consultant, it was becoming clear that a drug called Darolutamide was no longer suppressing the cancer. My PSA was starting to rise above the trigger level of 2 six-months ago and is now six-times higher than that. There were uncertainties about whether the trial would be re-opened. They vapourised. I started to do so some on-line resarch.
I found clues as to my condition in a decision of the UK Medicines and Healthcare Products Regulatory Agency published on 5 April 2022. It was entitled "Lutetium (177Lu) vipivotide tetraxetan in the treatment of prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC)". I don't wish to raise alarm you chaps, but this is the first time I have heard that my cancer was CASTRATION-RESISTANT. I shall be having words about this at my next consultation. But there is no point in concealing the fact that prostate cancer is not sex-life enhancing, at least not for me. But hey, we have been blessed with four children and nine grandchildren and an ongoing rich and fulfilling life.
Nevertheless, my private parts are not what they used to be, and that is something my wife and I have learned to live with amicably. Castration-resistant, however, came as a bit of a shock. I prefer to focus on the reasons why the decision was taken. In lay terms my cancer has spread and is not responding to previous treatment, so authorisation has been given to extend its use to patients like me.
Hurrah, even if they have been targeting my nuts.