Low Platelets

[Murph256]

I underwent full pelvic SR ending in June of 2019. Since then, my platelet count has been steadily dropping from a baseline level of about 150 to 113 today. I have experience a similar albeit much more gradual decline in my Hbg count. My questions are: How long after radiation can I expect my platelet count to fall? Is my current count of 113 anything to worry about? At what level should I be concerned? And can anything be done, within reason, to reverse or at least stabilize my falling platelet count?

[BigTex3]

Good morning. I’ve even struggling with low platelets and HGB after Xofigo, spot radiation and chemo. My oncologist gives me a transfusion when the platelets get to 10. Also a RBC transfusion when the HGB is below 7. I wouldn’t be worried at 113. If you were at 13 it would be a different situation.

Good luck and hopefully your numbers start to go back up soon.

[Murph256 in reply to BigTex3]

Thank you. That’s reassuring.

[LearnAll]

Fall in platelets is a common occurence after PCa treatments. Your level of 113000 is NOT dangerous. When platelets count falls below 40,000 , the risk of bleeding goes up and if platelet count falls below 20,000, the risk of spontaneous, internal organ bleeding rises dramatically.There are 2 ways to increase platelet count (1) Prednisone (2) Boiled water of Papaya leaves.

At your level (i.e. 113000) ,I will not do any intervention and most likely, the count will start rising as weeks pass by.

[Murph256]

Thank you. I will look into the papaya leaves.

[TylexGP]

My platelets bounce around since HDR Brachytherapy and EBRT last July and September 2022. Low was 123 high 183 currently 159.

[Tall_Allen]

Usually whole pelvic radiation affects the white blood cells only. But your RBC and platelet levels are just slightly low. I would attribute it to the Orgovyx - testosterone encourages the bone marrow to produce those.

[Murph256 in reply to Tall_Allen]

Thank you. Is it likely that my platelets and Hgb will stabilize at these levels now that my testosterone has bottomed out, or could this be a worsening problem?

[Tall_Allen in reply to Murph256]

Sorry, I have no idea. Prudent to monitor. Erythropoietin and platelet stimulants are possible if it gets too low, but you have quite a way to go.

[Murph256 in reply to Tall_Allen]

Thank you.

[Mojar in reply to Tall_Allen]

That is my case now after ebrt whole pelvic rt 20 months ago. Is there any way that I could do or take to increase my WBC? At present my wbc count is 3.68 up from 2.85 last Jan 2022.

[Murph256 in reply to Mojar]

My WBC has declined from 8.1 to 4.6 over the past 24 months, but it’s still above the low end of normal. My RBC has declined from 5.2 to 4.4 in that time, a much less pronounced decline. I’m hoping all of these counts stabilize soon.

[timotur]

After HDR-BT/ IMRT/ADT, all platelet, RBC, Hg, WBC counts were about 15% under lower-limit normal. Now three years after treatment, all but WBC’s have recovered.

[GeorgeGlass in reply to timotur]

Have they recovered to normal levels while on adt?

[timotur in reply to GeorgeGlass]

Two years after my last Lupron shot in Sept 2020, WBC's are still about 10% low now, but slowly improving. Thus I am still immuno-compromised.

[Murph256]

I have to say, in hindsight, I really wish I had not done the salvage radiation. My PC must have been systemic by the time I underwent SR. I likely incurred all that damage to my marrow and sexual function for no benefit. I remember my RO was wildly optimistic about my SR. My MO just rolled his eyes. The telltale sign was all local samples and nodes taken during surgery were clean, but I had PNI. Hindsight always being 20/20.

[oilcan4]

My husband had prostrate with bone mets. When he started Xofigo, his platelet count was 124,00. after 3 infusions, it dropped to 40,000. He had to stop the Xofigo, but his platelets kept dropping. He developed Tachycardia. The hospital gave him a platelet and a blood transfusion; but several days later, his platelets started dropping again. His last blood work showed his platelets at 6,000. They assumed the cancer had invaded his bone marrow.

[Murph256 in reply to oilcan4]

I’m so sorry. I hope and pray he improves. 🙏

[oilcan4]

Thank you, but unfortunately he passed a little over a year ago.