The nuclear option: Pluvicto #1


Months since last chemo infusion: 4 Weeks since first Pluvicto treatment: 4 Days since last serious fall: 17

Zelda: You had your first Pluvicto treatment a few weeks ago.*


Zach: Yup.


Zelda: Wanna tell folks about it?


Zach: Why not. It’s the last thing to try—the last option. 


Zelda: The last option right now. 


Zach: Whatever. It might buy a little time, according to the TV commercial.


Zelda: They're advertising on TV?


Zach: Yeah. I guess the market for this stuff is bigger than we thought. Anyway, the commercial has a guy playing golf, and the narrator says Pluvicto helps “you be you for longer.”


Zelda: Does that mean you have to take up golf?


Zach: Now you’re getting it. You know, people who golf don’t actually live longer. It just seems like it. Because: They’re golfing. 


Zelda: Ha ha!! So what was the actual treatment like for you?


Zach: Easier than chemo.


Zelda: I hope so. Anything surprise you?


Zach: How friendly everyone was. Especially the nurse that kept bringing snacks.


Zelda: She was nice. I half expected everyone to be in hazmat suits. You know, since it's nuclear. But they were pretty causal in their regular scrubs and white coats.


Zach: So casual. They made a big deal about staying 6 feet away from people for 4 days after the treatment. But they didn’t seem to care about staying away themselves.


Zelda: I was glad they let me be in the treatment room with you. And you had a comfy recliner to sit in.


Zach: Surrounded by paper taped to the floor, in case of spills.


Zelda: They made me step out during the injection, but it seems like it went pretty quick.


Zach: Took about 15 minutes. 


Zelda: I barely had time to crack a book. When I came back, you were waiting for the CT scan. What was the point of that again?


Zach: To make sure the radiation was going where it was supposed to, not just stuck in my arm.


Zelda: Seems like the whole thing took maybe 3 hours. 


Zach: 2 hours longer than it needed to, but yeah.


Zelda: And then I drove home with you glowing in the back seat. How are the side effects?  


Zach: Of your driving?


Zelda: Let’s not go there.


Zach: The worst part was sleeping in different rooms for the first 3 nights.


Zelda: That was the worst?


Zach: Pretty much. 


Zelda: So you’ve been feeling ok otherwise?


Zach: Just the usual suspects: Loss of appetite, constipation, nausea, chills. And fatigue. On the plus side, I can nap now. I can nap first thing in the morning when I sit down with coffee. In fact, I might be napping now. 


Zelda: That would explain a lot. 


Zach: Hopefully it’s all worth it. We’ll know when we get the labs next month.


Zelda: And you’re scheduled for 6 treatments?


Zach: 6 weeks apart. Takes us through next August.


Zelda: Anything bugging you right now?


Zach: My hands and feet are still fucked up.


Zelda: Neuropathy?


Zach: Yup. Seems like it’s getting worse. At first, they were just numb. Now they’re always tingling. Pins and needles. 


Zelda: Maybe that’s a good sign.


Zach: Hope so.


*Pluvicto [Lutetium 177]: A radioactive isotope used to treat metastatic castration-resistant prostate cancer after chemotherapy.] More about Lutetium 177

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