Writing for my partner, who is exhausted and down after 5 months ADT and 28x radiation.
Returning home he went for CBC, and it came back high MCV MCH, low RBC and leukocytes. His primary w/0 knowledge of cancer tx says nothing. I'm not content with this, I hate to see my partner so tired and unenthused.
He is 66 and began taking iron supplements after we discovered his age 50+ vitamins have no iron (and his diet has been poor). But now I'm thinking that may not be the issue.
I know radiation fatigue can do a number of folks, as can ADT.
Are the high/low values indicative of anything? Is there something more he can do?
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quietcorner
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I have some issues that caused low grade anemia with my blood counts deteriorating slowly. After18 months on ADT my blood work has been deteriorating fasterand making my anemia worse but not critical.
After about 30 sessions of radiation (out of 40), my blood counts had deteriorated to the point that my hematologist decided I needed a blood transfusion, wich helped greatly ... at least in the short term
I'm 77. I had a similar problem recently, October through November, with low B12, hemoglobin, hematocrit, and RBC, (but normal MCH and MCV). Shortness of breath, muscle pain from little effort, fatigue, anemic. The word "exercise" exhausted me. I simply did not have enough red blood cells to carry oxygen to the muscles. I took iron sulphate 65 mg and increased iron in diet, also took B12 500 mcg daily, also increased lycopene intake. After two months, I feel back to normal. However, I ran across an article that suggested B12, an antioxidant, and actually all antioxidants, cause cancer metastasis proliferation (in mice), and it seemed my metastasis in spine got inflamed, so I cut down on D3, E, and stopped B12. I still take iron once or twice a week. The body does not make B12 so it's best to get from diet. I guess beef avoidance means you get from chicken or fish, I avoid dairy and eggs due to cholesterol. But iron is hard to get in a low calorie and no beef diet. Good amounts of iron can be found in clams and beans, (clam chowder and vegetarian chili).
",,,The new findings, authors from both studies said, suggest that cancer patients and people with an increased risk of cancer should avoid taking antioxidant supplements."
",,,Based on the available evidence, Dr. Bergö said he was extremely concerned with the aggressive marketing of antioxidants to cancer patients. The data strongly suggest that using antioxidants “could be really dangerous in lung cancer and melanoma, and possibly other cancers,” he said. “And because there’s no strong evidence that antioxidants are beneficial, cancer patients should be encouraged to avoid supplements after they have a diagnosis.”
I echo the comments you read here regarding exercise. In 2022, I had 3 mos of ADT/Niraparib, SBRT, and 3 more months of ADT for Gleason 9 (4+5). I walked 15,000 steps daily during treatment and since the end of treatment I work physically 5 days a week as a house framer. I feel good (not withstanding arthritis issues) - lost 30+lbs and striving to lose 15 more. PSA has been stable at .09 for a year. Get your husband walking 10,000+ Steps daily and doing strength training at least 4 days a week - it will change his life. I am 72
I too will join the “Exercise Choir”. Get him moving and start with light weights. I lost 12 pounds and 2 inches off my waist and have energy and anemia has gone away. Costs very little to walk. Perhaps a good pair of sneakers. At 78 I now feel like I am 50.
People undergoing cancer treatment are often anemic. In general, Low RBCs indicates low production, of which there are many causes including “anemia if chronic disease.
Nutritional deficiencies are as follows:
Low MCV may mean low iron. High MCV may mean low folate and/or B12. Normal MCV may mean low levels of iron and folate or B12!
The only way to know for sure is to periodically do lab testing: ferritin, iron, TIBC, folate, and B12. These can be ordered and interpreted by any general physician.
Anemic for years due to PCa, radiation and chemotherapy. Out of the blue, hemoglobin not recovering after treatments. Found out had folate deficiency (was not present just 10 months prior.
Adding on to what MaxWife said:the sTfR test can help distinguish between anemia of chronic disease and anemia from other causes. Also, f you test for Iron and it is low and you supplement it, continue to test Iron regularly to see whether the supplement is actually bringing iron levels up.
Thanks, everyone. Unfortunately his PCP did not test for folate or B12 deficiency. She is actually a nurse practitioner and knows nothing about prostate cancer nor ADT, so she doesn't know what to test for. I guess that's the way with specialization nowadays.
My husband had been walking 3.5 miles everyday through 4 months of ADT, up until the time he went to Jacksonville for his radiation treatment. It was in those 5 weeks (28 tx) that he stopped walking. I've also noticed that he has lost most of his body hair since going to radiation. For some reason it seems the radiation affected him more than the ADT.
Great reminder!He had been drinking copious amounts of water during RT to inflate his bladder, and I'm sure he flushed the B12 away. Also, he does eat antacids.
He has an RO in Jacksonville, FL, where he was treated. We live 6 hours away from there and I thought there was no MO near us but I am wrong, I just looked and surprise, there is one about 2 miles away. I should've remembered this because my mother, 85 y/o BCa survivor stage 4 and still alive and kicking after 4 years, has her.
Consult with your doctor since the anemia is associated with high MCV and MCH (macrocytic anemia) which is usually and indication of low B12 or folate.
I did radiotherapy back in June. This was after chemo and I'm also on an ADT regime. I found the radiotherapy made me more tired than the other treatments so I don't think your husband's situation is unusual. I couldn't get through a normal day without feeling exhausted. I could walk the dog but that was it. It also knocked back all my white blood cells (neutrophils etc). I thought I would recover a lot quicker that I did so it was frustrating. But in the last month or so I seem to have turned a corner and I have enough energy so that I can work a full day without getting exhausted or I can do light exercise. So hopefully things pick up for your husband as well.
I'm not sure about supplements (personally I take vitamin D) but for me walking every day helped a lot so I'd say to try to get back to that. There is no way I could have gone to the gym a few months ago but I'll try to start back in the New Year. So my experience is that radiotherapy was really tiring and recovery has been a gradual process over a number of months.
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Importance of ADT
Any benefit to RP given likely extracapsular extension
Effectiveness of ADT
