Anemia on Abiraterone + Prednisone + Lupron

[dac500]

Since November 2023 I have been taking Abiraterone + Prednosone for castrate resistant metastatic prostate cancer. In November my PSA was 0.8. In the first three months it went down to 0.26. Yesterday, my PSA was 0.16. But my hemoglobin and hematocrit became low at 11.6 and 36% respectively. Can Zytiga cause anemia?

[StayingOptimistic]

did I read this correctly? You are castrate resistant for 11 years?

[dac500 in reply to StayingOptimistic]

Sorry, I corrected the post since November 2023.

[DamnPc123]

it cause anemia for my husband. He was switched to nubequa and 25 RT . Doing well Psa now .30

[vintage42]

"... Since November 2023 I have been taking Abiraterone + Prednosone... my hemoglobin and hematocrit became low at 11.6 and 36% respectively. Can Zytiga cause anemia?"

I have only been taking Abiraterone + Prednisone for only 2 months, and my hemoglobin and hematocrit are 14 g/dL and 41% respectively, still in the normal range. I will have monthly tests until August.

[Tonyliv]

ferrous oxide tablet helps.

[michael00]

I've been on those meds for 6 years. Anemia for me is iron deficiency.had iron infusions 3 times, the last one in January appears to have not helped as much. Numbers are low bit not as low as they were. Even though Iron is still low, Ferritin went up a lot so they will just watch it for now.

[Atlpapa]

I’ve been on ADT+ for 4 years and been anemic for at least 3. I take Erleda and originally Elagard then orchiectomy. My hemoglobin has varied between 10.9 and 12 and hematocrit in the 35 -36 % range. My RBC are also just slightly below range at 4.1. I was never sure if it was the ADT or Erleda. The Dr says it is very common to be anemic when on ADT. I’ve had my iron and b12 tested and that is not the cause.

[Pianodude]

I got a message from you asking about Zytiga. I actually have never taken Zytiga. I started out with Firmagon injections and was switched to Orgovyx and eventually they added Nubeqa. That regimen has been keeping my PSA very low. I do have side effects from it. Hot flashes, very tired, weakness are pretty bad, but are better than the alternative. Best wishes for you to be able to control your cancer.

[chefjlu]

Yes, in some people it can cause absorption issues with some nutrients. I've bounced in and out of anemia all my life, born borderline. Part of it in my case is blood type AB+. People with AB blood type and to some extent B tend to have less gastric acid. My doctors periodically run tests to check where I am but are not overly concerned as it hasn't dropped by a large amount. I just adjust my diet some and that helps.

[pe43]

See patientpower.info/navigatin...

"Androgens support the production of erythropoietin, which is a hormone that supports red blood cell production. However, hormone therapies for prostate cancer suppress androgens, lowering red blood cell production and hemoglobin levels."

Zytiga (and Lupron) will lower the androgen testosterone, which will affect hemoglobin formation.

[LongTimeRunning]

Yes, I've been slightly anemic (RBC, hemoglobin, hemocrit below reference range). Since starting Abiraterone + Prednisone + zolodex.

[jackwfrench]

I am HSPC and have been on lupron/abi/pred since Sept 2023 and my MO says I am not anemic by the numbers, but I am trending a bit that way. My PSAs have been consistently negligible and another MO says I should consider taking a break from abi/pred to reduce the SE. Other says there is no data about the cancer risk of dropping it from dual therapy. - Dilemma!

[RoseDoc]

Low testosterone levels will cause an anemia. The drugs you are taking bring testosterone to negligible levels so, that explains your anemia.

[dac500 in reply to RoseDoc]

My testosterone is always <20 when taking ADT since November 2018. I had practically no anemia until recently when I have mild anemia (Hemoglobin 11.6 and Hematocrit 36. This is after being on Zytiga for 5 months.

[RoseDoc in reply to dac500]

The Zytigae tipped you over the edge.

[Hidden]

It's common to develop mild anemia, as your testosterone levels become that of a female, so too does your hemoglobin .

[Eieio]

levels reduce erythropoietin stimulation and direct effects on bone marrow, leading to decreased RBC production.

possibly interventions like erythropoietin-stimulating agents (ESAs) or blood transfusions

Interventions:

• Use of ESAs for anemia.

• Iron supplementation if needed.

• Growth factors (e.g., granulocyte colony-stimulating factor) to boost WBC recovery during chemotherapy

I have the same situation as historically anemic and both ADT and chemo made it worse. It’s a cellular level problem in regardless of my supplementation, which is significant didn’t matter..

[Eieio]

during chemo. I also got to keep the WBC up to a functional level.