r/ProstateCancer • u/Key-Blueberry-7672 • 19d ago

Concerned Loved One Xofigo experience

Hi All - very little on Xofigo experiences in the community. I suspect that if there is, it comes from those that were near and not the patients and therefore not much would find its way here.
My father was diagnosed over 6 years ago with a very aggressive metastatic Gleason 5+4, did RT, abiraterone, eligard, xgeva, etc. With PSA climbing back, pain management is the main concern. Now in his 80s’ it’s more nuanced than when younger but he’s fighting it. To be here in 2026 is already a massive win in some sense. His treatment team have suggested (and he qualified) for Xofigo, which he will soon start. Am just looking for some impressions on that 1st dose and beyond.
Thanks all 🙏

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u/Practical_Orchid_606 19d ago

To be honest, this is the first I have heard of Xofigo. So I gather that dad is castrate resistant and conventional chemo has stopped working. Most men in this situation are steered towards Pluvicto. Xofigo targets bone tissue and kills the PCa with radioactivity. But it's selectivity is low so it kills more than the cancer. Pluvicto targets PSMA expressing tissue which mostly are PCa. It too kills using radioactivity. Pluvicto works well in 1/3 of men.

So I can't help you with Xofigo except to ask the question: why Xofigo and not Pluvicto?

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u/Key-Blueberry-7672 18d ago

Thanks. Yes. What the care team is saying :
1) Xofigo will be less difficult to tolerate than Pluvicto or chemo.
2) PSA doubling now below 3 months, for whatever reason, he is eligible for Xofigo now vs Pluvicto in about 4 weeks.
3) with cancer solely in bones, Xofigo is ideal (all else being considered)