Bone marrow infiltration

[MeliaQuinn]

Wondering if anyone has had prostate cancer infiltrate their bone marrow, and if so, are there any treatments to pursue? Thanks

[Tall_Allen]

Chemo would be my first choice.

[MeliaQuinn in reply to Tall_Allen]

Thanks Tall Allen! Anything other than Docetaxel that might work?

[Tall_Allen in reply to MeliaQuinn]

Some like to add carboplatin. Some use cabazitaxel instead of docetaxel.

[MeliaQuinn in reply to Tall_Allen]

Thank you!

[JLS1 in reply to MeliaQuinn]

Has the marrow infiltration had an effect on his platelets? My husband may be in the same situation. After his most recent,4th, xofigo treatment, his platelets dropped to 38. Hemoglobin down to 6.8. The oncologist said 95% chance it's due to cancer taking over his marrow, 5% chance it's due to the Xofigo treatment (which can depress bone marrow)

[MeliaQuinn in reply to JLS1]

I guess it is hard to know whether the Radium 223 or the cancer is the cause. His platelets and his hemoglobin were down after the 3rd treatment. He was given two blood transfusions. We haven't had any blood work now for about two weeks and I am anxious to get it done to see where things are. Best to you and your husband!

[JLS1 in reply to MeliaQuinn]

Thank you. Best wishes for you and your husband as well. I hope he improves.

[Luv2fish in reply to MeliaQuinn]

Hubby in same boat how is yours doing. One xofigo treatment did him open. Started low dose chemo. Platelets down to 9..

[Luv2fish in reply to JLS1]

Hubby in same boat how is yours doing. One xofigo treatment did him open. Started low dose chemo. Platelets down to 9...

[JLS1 in reply to Luv2fish]

Is the platelet count of 9 due to the Xofigo or the Cabazitaxel chemo? What are his RBC and Hemoglobin counts? If I recall correctly, Jevtana (Cabazitaxel) is esp hard on blood counts. I hope he's getting a platelet transfusion? Our MO wouldn't give platelets unless they went below 10, or unless he had a bleeding incident. (while the ER gives platelets if they're below 30!!) My husband's platelets dipped as low as 12 one time!!! - I was terrified he'd have internal bleeding....then that's exactly what cost him his life 2 weeks ago, on Wed., April 8th. I'm completely devastated. He was the most wonderful man on this earth, in every way!! Keep an eye on signs of internal bleeding, esp in the brain. Hugs and prayers that your husband can make it through this.

[JLS1 in reply to Tall_Allen]

I read somewhere that platelets usually need to be at 100 or higher for chemo, but they make an exception and lower that to 50 for some individuals. Do you know if this is true? (my husbands platelets just dropped to 38 after his most recent, 4th, Xofigo injection!! - VERY scared! He did well on the Docetaxel when he was first diagnosed in 2017)

[Tall_Allen in reply to JLS1]

I don't know. Perhaps his platelets will recover in time.

[JLS1 in reply to Tall_Allen]

Praying for that. Thank you.

[Danielgreer]

How did the doc find out it’s in your marrow?

[MeliaQuinn in reply to Danielgreer]

I believe they deduced it from an MRI. He just finished 10 rounds of whole brain radiation after being hospitalized for swelling in the brain. I could quote the report if you think it would help?

[Danielgreer in reply to MeliaQuinn]

Thanks, I think I’ll ask my MO if she checked if it’s in my marrow. That sounds serious. Sorry to hear you have that and the brain radiation. The brain radiation was for the mets on his skull? Sorry to ask I just hadn’t heard of all this before. I hope you can find a treatment.

[MeliaQuinn in reply to Danielgreer]

Yes, we knew he had mets in his skull/calvarium along with several other places in his spine, ribs, etc. After Zytiga and Docetaxel failed (approximately 2 years of treatments), they began Radium 223 treatments. He had his third infusion on December 4th and was admitted into the hospital on December 6th because he couldn't stay awake. They treated him with two blood transfusions and 5 external beam radiation treatments on his spine. They discovered that he also had two compression fractures on his T4 and T10. He was discharged 10 days later and was readmitted two days later as he could not speak or make sense and could not see out of his right eye. I thought he had had a stroke but they did an MRI and the radiation oncologist believed that the mets in his skull had either infiltrated into the dura mater around his brain and/or bone marrow. We are a little confused right now but we will be seeing a new oncologist on Monday due to an insurance change so we will try to clarify. They started him on 16mg of dexamethazone (steroids) in the hospital and the swelling came down and he was able to speak again. We were discharged 4 days later from the second hospitalization (one day before his 56th birthday). So now we are trying to figure out what is going on. He is weak and fatigued and has difficulty walking. They are tapering him off the steroids so we are watching carefully to make sure he does not exhibit symptoms of brain swelling again.

[JLS1 in reply to MeliaQuinn]

OMG, What a nightmare. I'm so sorry. My husband is going through a similar situation right now. 4th Xofigo (radium 223) on Dec 5th, and on Dec 20th his blood numbers plummeted. VERY scary! I hope your husband improves. May I ask where he's being treated?

[MeliaQuinn in reply to JLS1]

We are in Denver and had been with Kaiser Permanente but we are hoping to start seeing an oncologist at UCHealth, Anschutz Cancer Center, University of Colorado

[Hidden]

I kind of wonder if I do. My one bone metastasis was in the pubic ramus. I actually fractured it at that point bike riding several months before my dx for stage 4, gleason 8 cancer.

I wonder if a fracture at the spot you have cancer will increase the likely hood, or guarantee you will get it into your bone marrow?

I had my pubic ramus bone met radiated with 3 sessions, total 2700 cGy. But I have still had a dull ache in that area, which has just gotten worse, making it so I cant workout at the gym unless it's in the pool, and I've been walking with a cane as it makes it less painful to walk. My doctor just prescribed gabapentin, so I am hoping that helps.

I have not had an MRI.

[MeliaQuinn in reply to Hidden]

I really don't know if a fracture makes it more likely or not for the cancer to spread into the bone marrow. My husband has had numerous external beam radiation treatments for bone mets in several areas of his skeleton. They seem to have worked well for the pain. He is still on Oxycontin and Oxycodone for pain. I hope the best for you and that your treatments work well!

[Hidden in reply to MeliaQuinn]

I appreciate your responding to my post, and the info helps. Today I am thinking my bone met pain is approaching that of pre-adt level..... How long does a beam radiation work to relieve pain? Mine was done about a year ago.

[MeliaQuinn in reply to Hidden]

My husband has had almost immediate relief after external beam radiation. Some areas have required more fractions than others (such as 5 days in a row vs 2 days). Maybe you need to have that area examined again to make sure the met is not growing or whether you have a fracture that hasn’t healed. My husband has two compression fractures in his vertebrae that cause pain.

[George71]

see link below.

cancernetwork.com/news/dram...

[MeliaQuinn in reply to George71]

Thank you for the article!

[Hidden]

Did his doctor say if his blood numbers are OK for chemotherapy?

[MeliaQuinn in reply to Hidden]

He has had Docetaxel and his most recent treatment was a 3rd infusion of Radium 223 on Dec. 4th. Apparently the radium was not working on the bone Mets in his skull/calvarium as an MRI saw infiltration into the dura mater or bone marrow or both? He just finished 10 fractions of whole brain radiation. We are in the middle of changing insurance carriers and oncologists. We have a meeting with our new oncologist on Monday to discuss where we go from here. Either the Radium or the bone marrow infiltration caused low blood counts. We haven’t had blood work since late December so we are hoping to redo the blood work soon. Thanks!

[lincolnj8]

2 yrs ago I was in the hospital getting blood transfusions (4) to stay alive, blood was around 3? Blood count they said is when your bone marrow works with the liver. If not working you end up with a high phosphate number. Mine was 3000. Supposed to be 150 or lower. Zytiga and prednisone (plus a lot of vitamins) is what worked for me. I get a Lupron shot about every 3 months I get infusions for bone strength about every 3 months (Zometa). Plus I get a B-12 shot every time I walk into the office. Blood is around 11.5 (should be 12.5) Its steady at 11.5 for 1 1/2 yrs now. . Back 2 years ago my legs, right side and ribs hurt. Still do at times. I have pain pills which I take a half a pill sometimes, not very often. It's oxycodone. Had a scan 2 yrs ago and the cancer was everywhere, bones, lymph nodes and organs. Psa is still undetectable for over a year now. Was at 800 two years ago. Wish my GP believed in psa testing 5 years ago ( I have a new GP now plus an oncologist). My yearly physicals with my GP and my work place didn't do PSA testing. I had no ideal what a psa test was 5 years ago. Anyway I hope this info helps you. Have a great day and enjoy a bowl of ice cream. Works for me

[MeliaQuinn in reply to lincolnj8]

Thank you!

[Zetabow]

Combined Chemo and ADT got it under control, at first I needed regular blood transfusions as I wasn't making any new Platelets and low White blood count. It did a lot of damage to Femurs.

[MeliaQuinn in reply to Zetabow]

Thank you - I hope the treatment has improved your quality of life and continues to do so!

[JLS1]

In case you're interested, I just found a trial for a promising drug that appears to not disqualify for low blood counts : ARV-110. It was recently fast tracked for mCRPC. :

clinicaltrials.gov/ct2/show...

medicine.yale.edu/ycci/tria...

targetedonc.com/news/arv110...

vegasinc.lasvegassun.com/ne...

[MeliaQuinn in reply to JLS1]

Hello - thanks so much for thinking of us! I looked at the trial and it appears my husband doesn't qualify based on the first exclusion criteria - no brain mets and steroids.