My husband Scott was recently taken off of Pluvicto after four treatments because his PSA skyrocketed and he developed liver metastases. He will be treated with chemo in the next month or two.
In the meantime he is sleeping all day long and has no appetite to speak of. I just checked his latest lab work and his hemoglobin is low at 2.90 (normal range 4.40 to 5.80) and hematocrit is low at 26.7% (normal range 41.0 to 50.0 %).
His oncologist has said nothing other than Scott's labs are "slightly low" and did not suggest any supplements, etc.
Has anyone had extreme fatigue due to low iron, and if so what was the treatment?
He doesn't have low iron, he has low hemoglobin and hematocrit. They are proteins produced by the bone marrow. Hopefully, his bone marrow will recover in time. A blood transfusion can help only temporarily. You can also discuss erythropoietin as a temporary fix, but if his bone marrow is depleted, it may not help..
Thahk you for the info! He has a phone visit with his oncologist on Monday. I was just making sure I shouldn't take him up to the hospital in the meantime. I have never seen him this weak and shaky. He's resting in his man cave at the moment so I guess I will just let him be and keep an eye on him. Hopefully his doc will come up with a good plan when we speak with him on Monday.
Did your husband have to have chemo before Pluvicto. My husband is going start chemo ASAP. He has Stage 4 prostate cancer since 2018 and Xandi and Zytiga no longer work.
He was on Xtandi for almost two years until it started to fail. Then they took him off of it and started Pluvicto. Now they are talking about chemo. Hope your hubby does well on the chemo!
Well, things escalated and he's now in the ER and they are hooking up fluids, etc. Maybe they can get to the bottom of what's going on, or at least get him comfortable.
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Oh sheesh. Hopefully they can stabilize him and he can get back home asap. Saying a prayer for Scott now.
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Thank you for that. He is home now after almost 4 hours in the ER. They gave him three bags of fluid because he was so dehydrated. He apparently is "on the verge of needing a blood transfusion", which is something apparently the Pluvicto caused. He has some other blood counts that are low as well. I guess we can say without a doubt Pluvicto was not the drug for him. Hopefully it will work great for others, but not my guy. He will be moving on to chemo after he stabilizes.
My husband's Hgb dropped to 5 from CLL and chemo. He needed 5 transfusions in 2020 before his marrow could recover. It did recover to 14 (good for a CLL patient) over about a year's time, so a patient's marrow can recover. Saying a prayer this happens for Scott.
My wife is treated for low hemoglobin and low hematocrit at University of Colorado Health. Their stated range for normal hemoglobin is 12.1 to 16.3, well above what you stated as normal. Anything below 7 is automatically treated with a blood transfusion. My wife gets an injection of Aranesp every three weeks like clockwork. She used to get weekly Procrit injections. Both are erythropoietin replacements (as noted by Tall_Allen). They work very well for her. You might also ask about getting these two tests: 1) iron binding panel and 2) ferritin serum/plasma. Lastly, you might check in with a nephrologist to see about kidney function which, if dysfunctional, can be the source of erythropoietin problems that impact the bone marrow. The nephrologist can check for: 1) creatinine level and 2) GFR (glomerular filtration rate).
Tell your dear Husband Scott.....that we all have him our thoughts and best wishes.....Lucky him he has a place to hide out in...... his man cave......
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 05/21/2023 3:23 PM DST
According to the patient visit information from the ER this is what was found on Scott's workup:
1. Dehydration
2. Prostate cancer metastatic to bone (no surprise there)
3. Hypophosphatemia
4. Hypocalcemia
5. Anemia
Poor guy is a bit of a mess. He's somewhat better today, but still very weak and tired. We will be talking with his oncologist tomorrow to see what the next step is.
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