The diagnosis
“I was 66 when I was diagnosed. I had been having mild backache for a few months — I thought it was just age. My family doctor checked PSA: 95. We did imaging, and the bone scan lit up like Diwali. The cancer had already spread to my spine, hips, and ribs.”
“The oncologist was honest. He said the treatment plan was to slow it and control it for as long as possible. I appreciated that he didn't sugarcoat it.”
The first treatments
“I started hormone therapy with the LHRH injection, and abiraterone tablets. For the first 18 months, things were stable. PSA dropped to under 1. I felt fine.”
“Then PSA started climbing — 5, 12, 30, 80. By month 22, scans showed new lesions. My oncologist switched me to docetaxel chemotherapy. Six cycles. The chemo was harder than I expected. I lost my hair, lost 8 kilos, was exhausted for weeks. PSA dropped some, but bounced back within months of finishing.”
Discovering Lu-177 PSMA therapy
“My oncologist mentioned PSMA therapy. I had no idea what it was. He explained it — ‘smart radiation,’ he called it. He ordered a PSMA PET scan. My cancer cells were lighting up — meaning they had the target. He said I was a candidate for Lu-177 PSMA therapy.”
“My daughter started researching online. She found this site. She compared my options. Lu-177 PSMA therapy was available in Mumbai, where I live. The cost was significant — $6,000–$8,000 USD per session, $36,000–$48,000 USD for the full 6-session course — but Mediclaim covered part of it, and my children covered the rest. We started in May 2025.”
The treatment experience
“The first cycle, I was nervous. The day itself was easier than I expected. Arrived at 7:30 AM, the actual infusion was only 30 minutes. I was home by 1 PM. I felt mostly normal that evening — just tired.”
“The dry mouth was the worst part. I kept sugar-free candies in every room. Drank water constantly. After cycles 4 and 5, it became harder — I needed saliva substitutes at night. By cycle 6, my mouth was significantly drier than before treatment. It's improved some since, but not fully back to normal.”
“The fatigue was mild compared to chemo. I took 2–3 days easy after each cycle, then got back to my walks, my reading, my morning chai with the newspaper. Family time was uninterrupted — I just kept some distance from my grandchildren for the first 3 days after each cycle.”
What changed
“My PSA started dropping from cycle 2. By cycle 4, it was under 50. By the end of cycle 6, it was under 20. Six months after my last cycle, it's 12.”
“The bone pain that had bothered me for a year is mostly gone. My energy is better than during chemo. I'm walking 3 km every morning. I'm planning a trip with my wife later this year.”
What he'd tell other patients
“Three things:”
“First, ask about the scan early. If I had known to ask for a PSMA PET earlier, maybe I would have done Lu-177 PSMA therapy before chemo — easier on the body. Don't wait for your doctor to bring it up.”
“Second, the dry mouth is real but manageable. Take it seriously from cycle 1. Sugar-free candies, lots of water, see a dentist regularly. Don't wait until it gets bad.”
“Third, don't compare yourself to internet stories. Every patient is different. My PSA dropped a lot; my neighbor's didn't. We don't know why. Focus on your own journey.”
His wife's perspective
“My wife, Sunita, wanted to add something:”
Current status
Rajesh's most recent follow-up scan (April 2026) showed stable disease with no new lesions. His team is monitoring with PSA every 2 months and imaging every 4 months. If PSA rises significantly, options would include re-treatment with Lu-177 PSMA therapy or transition to other therapies.