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Kevin Midgley's avatar

I haven’t reached the need of going to some exotic treatment like Pluvicto but I’m not sure that I would even if I had a need. As I understand it in Canada, the cost is not covered by Medicare and that means about a $200,000 bill for four treatments at $50,000 each which are necessary to save you an estimated two extra months of life.

where is the percentage in that🤷‍♂️

The method of how to prevent the dry mouth could be a game changer for some.

Instead i’m activating my stay healthy plan of taking 72mg of ivermectin daily along with curcumin capsules and pepper morning and night along with several cups of green tea each day.

My PSA after salvage radiation were rising steadily until the ivermectin plan came into place. Scores of.

0.01 to 0.02 to 0.03 in quick order have ended up stabilizing at 0.03. I will know the effectiveness of my plan in three months time when I have another PSA test.

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Keith R. Holden, M.D.'s avatar

Hi Kevin, I agree with you. That cost is prohibitive. Congratulations on stabilizing your PSA. I hope it persists.

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Tom's Blog's avatar

I am two injections out of six injections along my Pluvicto journey. Each Pluvicto injection is 6 weeks apart, my PSA has been rising steadily for about a year. Currently my PSA is at 7.55. My first Pluvicto injection lowered my PSA by half a point. Second injection it went up point. Background. I am in year 5 of my advanced prostate cancer journey. Like you, I had high hopes for Pluvicto, I kind-of-short-of still do. However I'm prone to positivity which keeps my hopes in the positive column. My survivorship strategy is to try and live a meaningful life with all its ups and downs while searching for enlightenment.

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J. P. Dwyer's avatar

Hi Keith, I've investigated radioligand treatments around the world. I've discussed the treatments with men who have chosen to pursue the care themselves in Austraila, India, Germany and Canada. The cost varies from $5K in India to free-for-all excessive pricing in Canada. The whole concept of clinical trials is ripe for conflict of interest whenever docs from COEs involve themselves with Pharma.

When countries with national healthcare begin using treatments that have not been pursued in the US and those treatments work well and inexpensively - think transdermal tE2 in the UK in place of Lupron for ADT - you know that the absense of a treatment use in the US is caused by there not being enough profit in the development of a treatment drug for Pharma to get involved. It continually pisses me off, but I know it is how the American medical system has been constructed. I don't have to lîke it.

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Keith R. Holden, M.D.'s avatar

Hi JP. Yes, that recurring theme pisses a lot of people off.

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Anthony Feig's avatar

"In addition, this phenomenon of a suboptimal control arm is widespread in pharmaceutical-sponsored clinical trials. Why? Poorly designed control arms that don't allow life-prolonging therapies potentially make the study (drug) look better than it is."

Bang, there it is.

(And yet, it takes me months to get a non-medical, anonymous questionnaire approved through my local IRB.)

You wrote a fantastic article: heavy on the science but very readable, layered in a compelling way, and on an extremely important topic. Thanks.

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Keith R. Holden, M.D.'s avatar

Hi Anthony. Thanks so much!

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Jim's avatar

Sartor at Mayo infers often that perhaps these 4th and 5th line therapies ( i.e. Pluvicto) would work much better earlier on before the boys get beat up physically with all the hormone treatments and cancer evolution...

When I was first diagnosed in 2019, PSMA was in US trials, Triplet Therapy was not SOC ect...Makes sense to me that Pluvicto as first line after surgery or localized radiation would be very beneficial...

Good topic again .:-)

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Keith R. Holden, M.D.'s avatar

Thanks, Jim. I truly believe that almost all therapies work better when used before the human body has been ravaged by disease and multiple other treatments, especially chemotherapy. I look forward to seeing what Pluvicto can accomplish in early CSPC, especially those with high SUV.

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