Advanced prostate cancer and Low Hb.

My father was diagnosed with advanced prostate cancer with bone Mets his psa was 228 and hb was 13

His prescription was

* January'18 calutide+zoladex

*February'18 calutide+zoladex

*March'18 calutide alone

*April Psa test 0.98

*May '18 calutide only

*June'18 calutide

We checked his CBC that time his hb was7.4 .. his LFT was normal

We had to transfused blood

*July'18 .. calutide

*August'18 calutide

*September'18 psa test=2.8. Hb=11

*October'18 calutide

*Novemberber '18 calutide

*December'18 psa=11.5 hb=8.5

Doctor change medicine casodex+zoladex

*January'19 blood transfusion psa=9.56

Casodex+zoladex

*February'19 his psa=7.8 hb=7.4

My question is that why his hb becoming low and low . We transfused blood many time during last year .

How his psa responding to hormone therapy

Is he getting castration resistance?

[pjoshea13]

He has been on Bicalutamide (Calutide/Casodex) without ADT (e.g. Lupron), but his hemoglobin (Hb) has been low enough to warrant transfusions. When testosterone [T] is very low, the red blood cells which contain Hb are reduced in number. Bicalutamide alone will not reduce T - do you know what his number is - presumably, it is quite low?

"Is he getting castration resistance?" He isn't yet on castration therapy [ADT] - so no (if I read your post correctly and his T has not become "naturally" castrate, in the therapeutic range.)

-Patrick

[pjoshea13 in reply to pjoshea13]

Oops - I misread "Zoladex" as something else. He is on ADT & PSA is rising, so has become resistant.

Apologies, -Patrick

[Tall_Allen]

Yes, he is castration resistant, as I answered before. It hasn't changed since the last time you asked. Why do you ask the same question?

healthunlocked.com/advanced...

[NPfisherman]

Two posts within 5 days--interesting--agree with Allen and Patrick--Casodex, an anti androgen is usually given with Zoladex , an LHRH agonist--his ADT was kind of intermiitent--why he was on the casodex with the zoladex yo yo therapy is beyond me...his response to the combo now is certainly not as strong as initial treatment with both 2 years ago

chemocare.com/chemotherapy/...

As for the anemia...Did he have any anemia issues before? Did he have GI bleeding, blood in his urine, iron deficiency, on dialysis or kidney failure--lacks erythropoietin, does he have a chronic disease process..?? Just a few reasons for anemia

I think you should get Dad to a center of excellence or get another opinion ...

I know you are concerned, but posting this again did not result in a better answer..

Good luck,

Fish

[Hidden in reply to NPfisherman]

I am concerning about his hb this time other detail is old addede for better understanding of case .

[NPfisherman in reply to Hidden]

Get him to a center of excellence if possible...His chronic anemia could be a result of gastrointestinal bleeding--does he have dark/black stools(poop) that look like tar?? Do his kidney's work OK ? Does he have any other chronic medical problems? Does he see blood in his urine?

If you can't answer these questions....then get him to a center of excellence.....where are you located?

[Magnus1964]

I am on xtandi and my Hb is low. My Uro sent to a Hematologist who prescribed 150 iu of iron.