Declining red blood cells.

[Poollover]

This Poollover, and I'm stage 4 prostrate cancer. My anemia is slowly getting worse. I'm on Orgovyx and Zytiga which brought my PSA to 0.78 from 12. Where do I go from here. In June I'll be 87. Terry

[Tall_Allen]

Have you switched to dexamethasone?Have you used docetaxel yet?

[Poollover in reply to Tall_Allen]

Not yet, I'm waiting for my next blood test, but can tell by how I feel that I'm getting weaker.

[Poollover in reply to Tall_Allen]

Now I have switched to Dexamethasone 1-mg.

[Chipnick]

Make sure they check for b12 and iron deficiencies. Often this is the PCa, but sometimes there are other/additional causes.

[Cooolone in reply to Chipnick]

Links to the B12 & Iron deficiency correlation to PCa? I'm curious, not questioning... Haven't seen that before and would read about it.

I have borderline Anemia induced by the use of Lynparza, but is a well known and documented issue. Have felt a nudge of additional fatigue, but over time it has lessened or I've become used to it. Will accept it as my PSA is still stable and below detectable (knock on wood and keeping fingers crossed) lol. But was low on B12 at the beginning, so curious...

[EdBar]

My oncologist prescribed iron supplements for my anemia and it did the trick, took a couple of months to see results in my bloodwork. If you take iron supplements it’s important to have iron levels tested regularly, too much iron is not a good thing. I’ve been taking iron for a few years now and no issues. I take it in the evening on a full stomach for best absorption.

Avoid B12 supplements it fuels cancer growth, this is per my oncologist, Dr. Sartor at Mayo. Vitamin E is the other to stay away from.

And if I was 87 and my PSA was 0.78 I wouldn’t even consider docetaxel (chemo). Focus on QOL, it’s awesome that you’ll be turning 87, congrats.

Ed

[dhccpa in reply to EdBar]

Interesting that you take iron on full stomach. I've read elsewhere to take on empty stomach, but I've done both without ever determining which is best.

[EdBar in reply to dhccpa]

That’s just the way I do it, I don’t like taking any supplements without food, I feel that they’ll just pass on through.

[Poollover in reply to EdBar]

Thank you about my age. I'm trying to hold on to my active life, but it's becoming harder.

[garyjp9 in reply to EdBar]

Ed, was your iron level already measured as low before you started on the iron supplement?

What do you think Sartor would advise if someone's B-12 level was low?

[EdBar in reply to garyjp9]

My bloodwork showed that I was anemic which is fairly common with long term ADT. I’m honestly not sure what he would recommend, probably to try and consume foods that contain it like meat.

Ed

[garyjp9 in reply to EdBar]

I am anemic too. My conundrum is that I have been trying to minimize red meat, so I need some consistent dose of B-12. I am hoping Dr Sartor might say that it is fine to take until normal levels but do not exceed that.

[EdBar in reply to garyjp9]

Sartor told me red meat has no impact on cancer, diet in general has little impact. I eat a healthy diet but it’s more from a heart healthy and healthy weight aspect. There plenty of lean red meat options out there. Fish, shellfish and poultry/eggs are good sources of B12 and protein. Sartor is a hard no on B12 supplements.

Ed

[garyjp9 in reply to EdBar]

Thank you, Ed

[Tinkudi in reply to EdBar]

Do you have any more information about staying away from b12 supplements

[EdBar in reply to Tinkudi]

Nope, only what Dr. Sartor told me which is good enough for me. He’s probably in the top 10 prostate cancer specialists in the world.

[Tinkudi in reply to EdBar]

Thanks. Many older folks supplement b12 and I wish they knew this

[Tinkudi in reply to EdBar]

He did not say why it is bad ? Was he a hard no on vitamin E too ?

[EdBar in reply to Tinkudi]

Yes he said prostate cancer loves them

[OFPF16]

I have the same fatigue and anemia. My MO sent me to an Endocrinologist where the results showed that I had endocrine insufficiency. With the concurrence of my MO, I was switched from Prednisone to Hydrocortisone. I still don’t feel any different but my labs showed it helped my anemia. Has anyone heard about this switch to Hydrocortisone? I hope you feel better soon.

[garyjp9 in reply to OFPF16]

Could it be that your results showed an "adrenal insufficiency"? I have it also. It arises in a small number of men when they taper off the abiraterone/prednisone, which reduces the adrenal glands' normal production of cortisol and aldosterone. For most men, their adrenals pick up the slack as the medication wears off. In our case, that has not happened. Hydrocortisone is the preferred medication when that occurs.

[j-o-h-n]

And I'm 87 already..... (1936)....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Poollover in reply to j-o-h-n]

Thanks John-- shall we arm wrestle.

[j-o-h-n in reply to Poollover]

LOL......... How about just flipping a coin?............

Good Luck, Good Health and Good Humor.

j-o-h-n

[Mormon1]

Zytiga is a miracle drug. As to a poor hemaglobin cbc add Vitamins D3, K2!and Hemaplex ( over the counter) eat red meatsb( I eat chicken, pork and lots of salmon). Eat lotsof broccoli rabe and sweet potatoes. Throw away the fake ketchup and substitute Pure honey; its great on fries. Throw awaybliquorn i was a 11,000’psa with metastatic prostrate cancer. Thank God for past 3 years My psa is less than one and all cbc measurements are normal. You have to want itnand work for it. A fewbprayers dont hurt

[Poollover in reply to Mormon1]

Thanks for the inspiration.

[Worked_the_World]

I am only 85 in June 10. I am getting a Male Blood Health test tomorrow, private pay. I want to see where I am, vis-à-vis anemia like you and sugar levels on Orgovyx, which causes a problem. I follow you because of our close ages.

My cancer is allegedly contained within the prostate, but my MRI and CT next week ahead of my SBRT on April 29 may give a different story.

Hang in there, my friend.

[Poollover]

That your cancer hasn't spread outside of the gland puts you in a better place medically than me. Let's hope it stays put.