Platelets are below 19 and doctor says chemo would be too dangerous. Any ideas for other treatments I could use? PSA is 251 and rising. Already had chemo, LU-177,AC-225, Xanadi, Abby and radiation. . Also did AD degrader and liquid bio showed no matching mutations.
Thank you for your input.
Thank you for your reply, yes have bone mets in spine and other places.
You could discuss having ADT (lupron, fimargon or similar drugs) or any of the new anti androgens (darolutamide, enzalutamide, zytiga, apalutamide). For chemo or Xofigo need to consult with hematology.
Hi
I have been wondering the same things for several years as my platelets typically sit in the range 12 - 25 due to Idiopathic Thrombocytopenia (ITP). Neither ADT or zytiga impacted my platelet counts, but they did drop my haemoglobin pretty seriously, to the point where the combined effect of platelets and RBCs would disqualify treatment escalation.
Fortunately the PCa responded well to the combination of eSRT and ADT+ zytiga, and to date I'm in good shape. But my platelets continued to drift down and I recently commenced treatment for TP with eltrombopag, which is sold as Promacta in the US (Revolade here in Australia). My platelets are now heading upwards quite quickly (about 50 after only a week or so on the drug and now aiming to stabilise at around 100). Previous immune suppressants such as prednisolone and azathioprine didn't get me a decent response and had bad side effects.
Eltrombopag is 18 months away from coming off-patent and is pretty expensive at the moment, but it sure does a good job of stimulating platelet production. Depending on your insurance etc, it may be worth investigating.
Stuart
Hello, thank you for the informative response.
You can have injections to increase the platelet level thereby making chemo treatments safer. I had injections prior to my back surgery at UCSF and everything went fine. Your doc may not be knowledgeable enough to know this.
Hi, thank you. Are the injections infusions of platelets?
They first injected platelets but that didn't work. They all went to my spleen. Then they gave me an injection that I can't recall the name of and that brought my level above 100. I also asked the docs at UCSF about doing the same thing if and when I needed chemo and they said that is exactly what they would do. Remember the docs at UCSF are the best in the world. They know things other docs don't.
Check out Tall Allens recent post on Veru-111 and Sabizabulin.May work for you? Its about Tubulin disruption which accomplishes what Chemo does with a different approach.
Best,
Mike
Is there any benefit to postponing chemo treatments?
When to move on to next treatment? 
Has anyone experienced very low platelet counts with xofigo
Has any tried low Dose Chemo (IPT)?
Advanced Prostate Cancer - Alternative Treatments
