Zytiga working but

[michael00]

My zytiga seems to be working. In one year PSA has gone from 1230 to 0.48. Alk Phos from 782 to 106. Now tests are showing low RBC and low hemoglobin, they suspect blood loss somewhere. Is drop in those counts normal with treatment?

[Magnus1964]

I too experienced this while on ADT drugs. My research doctor sent me to a hematologist. She put me on an iron supplement.

By the way congratulations on the great PSA results.

[michael00 in reply to Magnus1964]

They are having me get a coloscopy first to check for blood loss. A friend suggested i go for a hamster with a gopro for the colonoscopy. First time i saw Oncologist laugh so much when i requested that.

[Magnus1964 in reply to michael00]

That a good one. Get your laughs where you can.

[j-o-h-n in reply to michael00]

Make sure you tie a string on the hamster so you call pull him out before he bites your Adams apple. Then you can put him back in the KIA Soul commercials.

75 years ago today those brave men saved our freedom, now don't let it dwindle away from us.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/06/2019 6:14 PM DST

[NPfisherman]

I am on Zytiga and my H/HH has dropped to 13/39.....not unusual.....just keep an eye on it....one of the SE of Zytiga.... I eat a healthy diet and make sure I get enough iron and B12...beyond that...it is no fun to be anemic... less energy/more fatigue....

Fish

[Tall_Allen]

I assume your ferritin levels are ok, so supplementing iron would be a bad idea (excess iron is toxic). It's a good idea to check for internal hemorrhage, but if the low RBC and hemoglobin is caused by lack of testosterone, you may benefit from erythropoietin.

[michael00 in reply to Tall_Allen]

Ferritin is low says 3

Does that mean anything

[Tall_Allen in reply to michael00]

Talk to your doctor about taking an iron supplement if there is no hemorrhage.

[michael00 in reply to Tall_Allen]

Thank you for the advice

[Jbooml]

At PSA 1200+ one might presume bone marrow involvement ie prior haemagenic malignancy. Yes not only the boney surfaces but the marrow machinery can be affected....But are your numbers are only marginally down?...the drugs are working but the battle continues. What about the red blood cells margins are they normal and not too large. Interesting in my case is that my MCHC is consistently low and my cell concentration high....my hematocrit is normal..what does that mean....My cousin, in conversation about things medically niggling, informed me that his consistently are nearly the same....I take that as it runs in the family. lots of small RBC's abound with lower O2 capacity? maybe its adaptive to where our ancestors adapted to....a very cold climate....maybe..as I write and muse, contributing to my consistently high blood pressure from a very young age.

The take home message is you've been very ill and you're recovering. watch the trend....improving declining or stable....i'm certainly not worried about my lot...i feel fine.