I'm gonna wear a sign in espanol about 30k men in Spain Dx with PCa/year, place blue ribbons, and fete my almost 5 year survival (10/13/14 is when I had a PSA at 555.2)
My best to y'all in this journey
Mahalo and Fight on
Randy
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Randy, first thing I noticed after starting ADT was "where is the O2 during runs", especially at the start, and noticed RBC's and Hgb were under norm. Then I started eating beef or chicken liver just once a week to boost B12 and iron, and noticed it helps a lot. Good running and bon voyage!
My HGB never quite got that low during the depths of chemotherapy, and my running was reduced to a zombie walk. It's since recovered to 13.0 at last check, about two months after starting Abiraterone.
Keep up the fight Randy, I'm inspired by your perseverance and attitude!
Mahalo - since the PCa Dx - I've been waaay more engaging and positive with cashiers, wait staff, people I see on walks, and esp my dental patients. youtube.com/watch?v=iPUmE-t...
The chorus of that song has ran through my mind so many times these last few months -- whether for good news after tests, the reduction or management of side effects or simply waking up to a new and glorious day to share with the ones that I love.
Been interleaving running, rollerblading and biking to get myself ready for a charity 5k in mid-September (knees wouldn't like training by just running). Seems to have lifted my spirits out of the doldrums.
This is a common problem. All my red blood counts are out of range too. I did notice they have recovered somewhat from my chemo days, but still out of normal range. It does affect your stamina.
Yea, don't "run" much - mostly a slog (slow jog) with walking breaks. I've done 33 marathons post PCa Dx in 2015. 2 hours slower
Did 4 miles up to The Notch on Mt Baldy at 7800 ft from 6000ft and had to stop a few times. The beer and fries at the restaurant were worth it! mtbaldyresort.com/hiking/
Mahalo for the concern, I never push too hard - I made it this far
My favorite hikes in that area when I lived in SoCal were up Ontario and Cucamonga peaks. A bit higher altitude than The Notch and you have to bring your own beer & fries, but the wildness made it worth it. But alas, I was younger then. I miss the San Gabes.
Hey Randy, I'm 70 and my dx was exactly 1 year ago. Results: Gleason 9 stage 3(no mets). PSA doubled to 28 and I've had: HDR Brachy, 25 days of IMRT and ADT (currently Zytiga and prednisone).
Here is last weeks CBC:
ComponentYour ValueStandard Range
WBC4.5 x1000/µL4.8 - 10.8 x1000/µL
RBC3.6 M/µL4.3 - 5.9 M/µL
Hemoglobin12.1 g/dL13.9 - 16.3 g/dL
Hematocrit34.1 %39.0 - 55.0 %
MCV95.5 fL80.0 - 94.0 fL
MCHC35.5 g/dL33.0 - 37.0 g/dL
RDW-CV13.2 %11.5 - 14.5 %
Platelets197 x1000/µL120 - 450 x1000/µL
MPV11.3 fL8.5 - 9.0 fL
ANC (Abs Neutrophil Count)3.6 x 1000/µL2.2 - 7.2 x 1000/µL
Neutrophils80.5 %45.0 - 90.0 %
Lymphocytes7.7 %10.0 - 50.0 %
Absolute Lymphocyte Count0.4 x 1000/µL0.5 - 5.4 x 1000/µL
Monocytes10.6 %3.0 - 11.0 %
Monocyte Absolute Count0.5 x 1000/µL0.1 - 1.2 x 1000/µL
Eosinophils0.4 %0.0 - 4.0 %
Eosinophil Absolute Count0.0 x 1000/µL0.0 - 0.4 x 1000/µL
Basophil0.4 %0.0 - 2.0 %
Basophil Absolute Count0.0 x 1000/µL0.0 - 0.2 x 1000/µL
Immature Granulocytes0.4 %0.0 - 0.4 %
Absolute Immature Granulocyte Count0.0 x 1000/µL<=3.0 x 1000/µL
nRBC0.0 %0.0 - 0.0 %
Absolute nRBC0.0 x 1000/µLx 1000/µL
MCH33.9 pg25.0 - 35.0 pg
So, I sent my world class MSK MO a text regarding my suspicion of anemia and his reply was:
"Yes agree very slight anemia
and treatment is culprit
Not much we can do"
Looking at your photo you look like your ready to scale Mt Everest! Today I only had a few beers and watched the Yankee game. Guess I have to step up my game!
OK, so far you have given me today's menu and now a Spanish lesson ( I'm a Spaniard,4th generation American and I'm barely conversant in the language). However, I did get the gist of your post. Best of luck in the 110km and your (our) ongoing fight.
It is easy to assume that anemia is entirely due to the androgen deprivation, but since your numbers are pretty low you may want to check your iron stores and B12 status which are common deficiencies and both needed for RBC production. Your high MCV points more toward low B12 (low iron causes a low MCV and low B12 is one of the causes of a high MCV). For B12, instead of a serum B12, the best test is a urinary MMA. It is a much more sensitive marker. Last week I had the opportunity to look at 60 labs where individuals had tested serum B12, CBC and MMA done at the same time. I was amazed that even when the CBC indicated a B12 deficiency and the MMA indicated a deficiency, the serum B12 was in normal range. Many of these labs had follow-ups showing a normal MMA once B12 was commenced. In my opinion, it is worth checking, along with an anemia panel to know your iron status. I do not think cancer patients should proactively supplement with B12 or iron, but if an issue is identified, it may be worth it to help with the RBC cound and fatigue.
Great point. I am experiencing the same problem. My primary did the full panel and my iron level was normal and my B12 was actually slightly about normal. But, my iron bind capacity (calculated?) was low. UIBC was low but iron saturation was considerably above normal.
What's a mystery to me is why did the deficiencies not show up when I first went on ADT but nine months after it was concluded? It could be because my testosterone is still way below preADT level.
Hi- From what you are saying, your numbers actually showed that you have plenty of iron. Low TIBC and low UIBC are indicators that you have enough. A nice level for iron saturation is about 30%. As iron saturation goes up, it indicates more iron in the body.
So, my understanding is we could have then one of three problems:
1) I am not producing enough hemacrit/hemaglobin, 2) I am losing it e.g., rectal bleeding which I don't appear to have as my doctor checked for that, or 3) Something is destroying it.
If it is ADT-induced, would it be not producing it? Do you know what is it about ADT that causes the low readings? Actually, I guess it is really the low testosterone. But, how does that affect the numbers.
Hi- You have the 3 causes right. ADT falls under the category of not producing. Testosterone is needed for RBC production through several mechanism, one is by increasing erythropoietin, the hormone made by the kidneys to stimulate RBC production.
Many thanks! That's interesting because my RBC is normal at 4.15 albeit the low end of normal. Along with that, the reticulocyte count is normal at 1.7. So, I still at a loss if the RBC is normal then why is hemacrit and hemoglobin significantly below normal?
BTW: I found this interesting publication (it has some age on it though) which echos much of what you have said. It states also recombinant human erythropoietin is seen as a remedy. But, that comes with some baggage of its own.
Also, found some interesting info here (boldness added):
" Strum and colleagues11showed that although haemoglobin levels recovered to 93.5 per cent of baseline level three months after stopping hormone treatment, full haemoglobin level recoveries to baseline level were generally achieved only 24 months after treatment completion. Interestingly, the rate and extent of haemoglobin recovery was significantly lower in older patients and in those receiving ADT for more than one year."
Years ago, when I was newly diagnosed & curative treatment had failed, I wanted to try raising testosterone without increasing estrogen. I ended up in bodybuilding sites. That's when I came across products for increasing oxygen delivery via nitric oxide [NO]. I use a nitroglycerine patch for that these days, but there are plenty of products:
The issue with extended exercise while on ADT (IMO) is that hypoxia in a tumor can induce a vigorous survival response. IMO it's prudent to to use NO - a natural vasodilator.
I had the same, first step was a colonoscopy to rule out any internal bleeding. That turned out fine so my medonc had me start taking ferro sequels supplements (iron). After a couple of months I’m back in normal range. amazon.com/gp/product/B00N6...
I was on Lupron for 6 1/2 years and I found out my anemia was from bad kidney function. The healthy kidney gives out a hormone called erythropoetin. This hormone tells your RBC's to mature, release their nucleus, and enter the blood stream. My kidneys are not healthy. Ask your doctor about your blood tests for Creatinin, GFR, and BUN. I go to an anemia clinic now and they give me shots of a synthetic hormone to keep my hemoglobin level normal.
Great pictures. I was declared with acrostic anemia march 16, 2019 - 2 years in. Prescribed vitamin 12. Vitamin 12 test came out normal. Numbers similar to yours, had a slight uptick for better last blood test. Slow decline in numbers since ADT started. Round and round it goes. Where it stops, nobody knows. Enjoy.
Hmmmmm my onc told me my bloods were remarkably unremarkable. Still the ADT, lupron + Xtandi gives me bouts of fatique abut 3 times a week. I have been walking 2 miles per day for awhile now and i can tell when im not going to do well the rest of the day, my legs and knees will feel somewhat rubbery and my gate is slower.
Yes, I am experiencing the same thing. I have been off Firmagon for about nine months but my testosterone has not recovered back to the pre-ADT values. That I believed is the key. My hemacrit/hemoglobin drop, which has been always slightly below normal due to Beta-Thalassemia, did not sink to the roughly same values as yours until six months off Firmagon. I will speak to my oncologist next month. My primary physician suggests a hematologist.
My blood cell counts etc were all below normal after RT and being on ADT, borderline anemic. I became so fatigued, I reached out in desperation to my PCa clinic and this space. The answers were to get more exercise, and, specifically, weight training, as much as I could stand. I also cycled 4-5 times a week, 15-20 miles at least each time. That helped a lot. Also got an iron scrip, which seemed to help the RBC, but not a lot. Over time, blood work has gotten better. I was also 35lb overweight, so I used the keto diet and lost the extra weight, which also left me with more energy.
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