Fever and Low Hg in bone metastases (... - Advanced Prostate...

Advanced Prostate Cancer
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Fever and Low Hg in bone metastases (Emergency)

jeevanc
jeevanc
14 Replies

Hi Everyone. My father has a advanced prostate cancer diagnosed September in 2016. PSA was 1045 in those days. oncologist gave zoladex 10.8 mg in every 3 months and zolindronic acid (zometa) in every 2 months. we started treatments in October 22 , 2016. up to April he was in good condition. he had 6.06 PSA level. But in mid of April he got a fever. up to this time he was given so many antibiotics for reducing his fever. but still he has fever over 100.5 c and he has 7.4 hg level. testicles was removed in September 2017. all the ontological treatments was stopped from may 2017. Now he is fully weak and he cant eat much more food. he was lost his weight from 67 kg to 52 kg. I have attached bone scan report here with. I am hoping from you all. what will be the available solutions for taking care of my father furthermore. are there any oncological treatments for this ?

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YostConner

I'm sorry your dad is having a rough time. We're treatments stopped because of the fever? Has the oncologist discussed Xtandi or Zytiga?

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jeevanc
jeevanc
in reply to YostConner

he didnt say about the drug. but he said we can try to give one time chemo. it can be positive or negative. sir are there any treatments for his furthermore.

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YostConner
YostConner
in reply to jeevanc

It sounds like there are still several treatments available. Chemo has shown some promise in early use, so if your dad can tolerate it, that might be a good option. Does this doctor specialize in prostate cancer? Where are you?

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jeevanc
jeevanc
in reply to YostConner

I am from Sri Lanka. We don't have doctors specialized only for prostate cancer. All are in Oncologist category. they treat all the type of cancer patients. when we give chemo treatments i have seen some of the paients are dead with in the moment after chemo treatment. that s why i am fear to give this ? cant we measure that he can tolerate this chemo ?

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YostConner
YostConner
in reply to jeevanc

I think it’s reasonable to talk with the doctor about your concern.

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eggraj8
eggraj8
in reply to jeevanc

You have a very tough decision to make. All I can do is give my opinion and tell you a little about me in how I reached this opinion. My cancer spread rapidly one year ago. I felt terrible. I was weak and did not like food anymore. Scans showed the cancer was in bones, liver and lungs. My oncologist who later would tell me that he thought I was a goner put me on Chemo which included Docetaxel and Carboplatin along with prednisone pills. Those drugs are tough to handle, but I did. Somehow, they worked and they stopped the spread of the cancer and now I am actually feeling much better. I just had my 15 infusion of the Chemo drugs and will continue them as long as they work for me. I also started XGEVA for the bones, that is also tough to take and hopefully it works.

My HGB level is below normal averaging around 9. I do not have any fever. When I asked my oncologist about the blood he said that all the PC patients have levels that are not normal and mine are OK and that he would give me a transfusion if needed.

My opinion is that Chemo will be hard on your father and could even shorten his life but it also gives him a good chance to recover. As life is a constant gamble on what is the best solutions to our problems I would go for the Chemo and pray that it works. My prays will also be with him.

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jeevanc
jeevanc
in reply to eggraj8

thank you for your ideas.

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gregg57

Does he have neutropenic fever from low white cell counts? If his hg is low, the WBCs might also be low. What are his WBCs and absolute neutrophil counts? If they are low, that would be a reason not to give chemotherapy. There is something called Neulasta that is used to boost blood counts. It's often given during chemo to deal with the myelosuppression caused by chemotherapy.

I'm not a doctor, but I would find out about that.

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jeevanc
jeevanc
in reply to gregg57

he had over wbc count before 2 months ago.(13250). Now he has normal wbc count. (between 4000 - 11000). we give to him blood two times. after hg level was 10.1. but after week it was reduced to 7.4. so what will be be solution ?

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Hidden
Hidden

Why is he so weak?

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jeevanc
jeevanc
in reply to Hidden

i think , due to low hg and side effect of poweful antibiotics.

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gregg57

I'm curious as to why treatments were stopped in May.

Not sure what can be done in this case other than giving blood, but I'm not a doctor so you should ask. His doctor might have some ideas about what can be done. If he has extensive bone metastases, it's possible that his bone marrow has been effected to the degree where it is failing. My HG was also low at the start of treatment, dipping just below 12 which is where anaemia starts. It was declining until I started treatment. It has gone up since starting treatment.

Here's an article on the subject:

ncbi.nlm.nih.gov/pmc/articl...

From the article:

Bone metastasis is a common complication in patients with advanced stage prostate cancer and might even be found already at first clinical diagnosis [1,2]. Depending on the extent of spread, bone marrow function might become compromised, resulting in anaemia and thrombocytopenia...

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Jasper2

The loss of weight along with loss of appetite is troublesome. This is cachexia and is typical of late stage advanced disease. Usually at this stage palliative care is the appropriate treatment. There comes a time for all with advanced PC to recognise that reality. You need to have a frank discussion with your father's oncologist to determine realistically what his options are.

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gregg57

Have they ruled out cancers of the bone marrow?

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