General Questions

[Lagovista2018]

I have some questions in regards to how often should my fiancé who has stage 4 prostate that met to the bones get his hemoglobins checked, he’s on hormone pill right now and will be starting injections next week. Also is it okay for him to take an iron pill as well as a multivitamin. He is very tired in the morning and afternoon should he take something else?

[ewhite999]

I go to the lab monthly for comprehensive bloodwork. I’m not sure if that is the standard. Best thing to combat tiredness is exercise if possible. I’d check with his MO on the iron pill.

[Lagovista2018 in reply to ewhite999]

Thank you

[tango65]

In general the anemia associated with ADT is managed in an individual basis. Iron may not be necessary since the anemia is a normocytic normochromic anemia. This article is a review of the hematological changes caused by ADT:

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

[Lagovista2018 in reply to tango65]

Thank you

[tango65 in reply to Lagovista2018]

Best of luck in this journey.

[Stegosaurus37]

This is a weirdo. I've been mildly anemic for lo these many moons long before any cancer. My oncologist (who is Italian-American) asked my ethnicity. I told him that my wife, the genealogy nut, got me to do a DNA test and I'm 20% Spanish - how that happened, I have no idea, but I think it's pretty cool. He said that was the answer; Mediterranean peoples tend to be anemic. Go figure.

[wagscure259 in reply to Stegosaurus37]

That would require a specific diagnosis Of thalassemia which is a specific disease where is a lack of either a beta or alpha protein which can be determined by a blood test . Anemia with ADT is associated with a reduction in RBC’s as testosterone reduces

[charlesmeyers1964]

the purpose of not taking a hormone pill or injection is thats what makes your cancer grow its called hormone growth so why hes taking shots for it is a question to me.

charlie

[Lagovista2018 in reply to charlesmeyers1964]

From what others have said as well as his doctor the hormone pill he’s taking now is a prep for the injection and yes it’s to stop the testosterone since he has prostate cancer that has metastasized to his bones. Apparently this is what they do to slow down the cancer from spreading more

[Lagovista2018 in reply to charlesmeyers1964]

He is taking a hormone pill. Sorry if I started he wasn’t. He’s also taking iron pills which he stopped due to he was getting constipated. Again this is the plan his doctors want him to take. I’m open to any advice. A lot of people on this forum have stated that they have done Hormone injections as well as hormone pills to stop the testosterone

[JimVanHorn]

Well the pill he takes is probably Casodex. When you start with ADT injections you get a large bounce in your testosterone and that is not good for you, so Casodex blocks that effect. I do not know how old you husband is but this anemia is probably not ethnic. I had my doctor check my hemoglobin every 3 months for the 6 1/2 years I was on Lupron. My kidneys got worse and I became anemic. One test that my oncologist did was called Ferritin level. It told me how much Iron is in my blood. I also asked him about Vit B12 2000 IU chewable. They gave me energy. I snore when I sleep and my breathing doctor gave me a CPAP mask and my oxygen was up to 98% most of the time. I took naps when I was tired and ate a balanced diet. At this time I have no cancer anymore, but I see the oncologist every 6 months. My PSA is 0.000.

Ask his oncologist all of these questions and look up the side effects of his shots on the internet so you know what to expect. If he is on Lupron the drug is used by infertile women to have babies, so don't waste your time reading about all of that. In men it signals the pituitary to stop the production of testosterone. This form of cancer is different from others and is slow growing, so just do what the doctor says and ask many questions. I got a second opinion at one point. But remember, just keep truckin'.

[pjoshea13]

He should not take iron unless he has been tested for deficiency - & deficiency is very unlikely.

askdrmyers.wordpress.com/20...

-Patrick

[Lagovista2018 in reply to pjoshea13]

He was anemic when he was admitted to the hospital over a week ago. Gave him a pint of blood. The docs were running so many test combo of his scope/biopsy he was urinating blood for a while after the procedure. While in the hospital they gave him a pint of blood because his levels were below 7

[Lagovista2018]

Yes he is taking casodex now. My fiancé is 45. I thought about buying some b12 to give him energy. He was taking iron but stopped because it was making him constipated. His urologist said it was okay for him to take the iron pill for his anemia and a multi vitamin ( Centrum Silver). He’s been getting nauseous in the morning and some evenings. Congratulations on you being cancer free

[charlesmeyers1964]

is the pills to continue to keep your hormones strong and active. what is the shot another increase ones hormone. if that is the case then your making him closer to dieing. prostrate cancer is controlled by our hormones the more u give the more active it is. the lupron/eliguard shot if that is what he is getting is to stop the hormone in ones body so make clear to the oncologist this is what his goal is or maybe u quoted the findings wrong. all the guys on this site will state hormone shot but its a shot to stop ones hormone and as for sex the more the treatments the less he will beable to function unless he gets a mechanical device to make him fully enlarged.

[Lagovista2018 in reply to charlesmeyers1964]

I’m just learning this as I go and I’m going by the plan his doctor is giving. Again we are new to this right now he is on hormone pills and on Monday starts his injections. From what others and his doctors have said the casodex (pill) is a prep to get him ready for the injection. But yes the hormone he’s taking is to stop the testosterone. Thanks for the advice I will definitely mention Lupron the the oncologist. We see him Monday

[Hidden]

Taking the iron pills will help, he should also take something to help with getting constipated. I have fought Anemia as well, and taking the iron will help him with his numbers. Also good to take calcium and vitamin D with the hormone therapy since it can cause the bones to thin. Take care of him and take care of you too!

[Lagovista2018 in reply to Hidden]

Thank you. I will buy some this week

[JimVanHorn in reply to Lagovista2018]

Well taking too much iron can be a problem so I would wait until the oncologist checks his blood and tells him what to do.

[Lagovista2018 in reply to JimVanHorn]

Thank you. His doctor just gave me a call and the hormone injection that they are going to give him is Trelstar instead of Lupron. Has anyone on here heard of it. His doctor said they use this instead of Lupron for all prostate cancer patients.

[monte1111]

Was sick so took pregnant wife's vitamin pill, got sicker, took more vitamins, got even more sicker. It was the extra added iron in the pills. So, from experience, be careful with the iron. I know you checked with your dr. but for others be careful.

[Lagovista2018 in reply to monte1111]

Thank you

[JimVanHorn]

I cut back my vitamins from Centrum Silver to just Multiple vitamins. With vitamins the extra just goes into the urine and only need smll amounts to keep you healthy if you are eating a healthy diet.

[JimVanHorn]

Trelstar is similar to Lupron. Both are ADT (Androgen Depletion Therapy‎). They fool the pituitary (in men) to stop making androgens (testosterone (T) ). However, some pituitaries can not be fooled and this therapy does not work. These men are called castration resistant and some on this site believe everyone with PCa (prostate cancer) eventually over time will become castration resistant. Both drugs have similar side effects, but Trelstar has a slightly better survival rate. Both drugs can be in timed released injections of 3 months meaning you only get one shot every 3 months! Lupron comes in generic called Eligard which may be cheaper than Trelstar. You need to read up about the side effects so he knows what to expect. Look on the computer.

So why is it important to stop production of androgens? Well, all prostate cells (normal and cancerous) have a "spot" on their cell wall called an androgen receptor (AR). When a molecule of T comes near or touches the AR then the cell begins to sub-divide and form two cells. Without T cell division stops. So even if you have metastases the cells can not keep making tumors outside of your prostate. They can attach to the bone (hips), soak into the bone, and leave a pock mark on the outside of the bone. These cells are stuck and die if there is no T. The bones get weakened and I took 1 Gm of Calcium (Dr,'s orders). At one point I had to use Xgeva injections (osteoporosis drug) to strengthen my bones. Now the testes no longer make T, but the adrenal glands (on top of the kidneys) normally produce dihydro-testosterone, and this is stopped by Trelstar as well. Remember there are billions of single prostate cells and some leave the prostate gland all the time. The body takes care of most of these with your immune system, so we need to stay healthy. So this whole thing is just a crap shoot and Trelstar does it's best. There is no cure even though we become symptom clear. PCa is slow growing and we all hope for another type of cure in the future. I am grateful for all the men who died, so we can have these medicines and dosages available to us. This site talks about all kinds of new therapies and some people use other cancers like breast or ovarian and apply the therapies to PCa. The is really wishful thinking but fun to read about. I am encouraged about genetic therapies and stem cells, but that may be a few years off. Some people are using genetic research of who had PCa in your family and what are your chances for getting PCa, but you never know where the answer is, so keep asking questions and keep on truckin'.

[Lagovista2018 in reply to JimVanHorn]

Thank you so much for the information. We’re open to all options. I know there is no cue but if we can get it under control then he can live a longer life.

[Crabcrushe]

You are amazing. My wife's the same.

How are you and your fiance lately?

[Lagovista2018 in reply to Crabcrushe]

Thank you. His chemo therapy treatments and hormone therapy is working and He’s doing well he had a Ct scan with contrast done last week and his cancer tumors have gone down from 2.1 centimeters to 16 millimeters. Even his urologist said his prostate has gotten smaller. He has a bone scan done tomorrow to see if he has any more mets etc. fingers crossed we will get good results too. I hope you’re doing well

[Crabcrushe in reply to Lagovista2018]

Praying.

Got a good feeling he'll be around a loooong time, as will I.

Reminds me of the day I met my Oncologist and asked him how much longer I had left. (Ad lib, of course.) He didn't blink and said "Many years." This after the doc I fired answered the same question with, "(whining tone) I can't tell you; I mean, you're stage 4 and it's doubled (psa from 1.2 to 2 .2 off 6 mo.). It's aggressive. A year or two, maybe. " I didn't let his door hit me on my way out.

I like "Many years." He's proving himself prophetic, too.

[Lagovista2018 in reply to Crabcrushe]

When we’re you originally diagnosed

[Crabcrushe in reply to Lagovista2018]

Like, August of '16, but I've had it forever, so my Gleason was 4/5 and I was taking overlapping leaks, nearly. Your hub's got a 3-year jump on me-at the rate they're popping' out stumbling blocks at these trials, he'll be whackin' mole for YEARS. I know I plan to be; my Queen and I have big plans for the crab that he will not enjoy.

Check out the recent Israeli finding, weapons of nutrition, stuff such as PH tools, as infinitum; she and I are actually enjoying ourselves when we beat crab butt and take his lunch money.

We will be tickled to help you two in anyway we can.