Is ADT causing anemia

Jeff, I was teasing Wayne a bit, because I called him and he said --yes, after hesitating. He wouldn't give over any of his bank account numbers though. He was suspicious.

@gently Yes, I was very suspicious. "Who are you? Who do you represent?" LOL.

"How did you get my number," was funny, too.

Waynerl, I am so sorry to hear about your issues with prostate cancer, lung metastasis, and anemia. I hope that your physicians are able to resolve these issues to improve your quality of life. I appreciate your post because I was going to post my experience to get feedback.

I was diagnosed with oligometastatic PC last September and have been on Orgovyx/abiraterone/prednisone since early November. I was doing well in the first several months with the only significant side effect being occasional hot flashes. My PSA is 0.08 and my testosterone is <3. I've been maintaining a vigorous program of strength training and aerobic exercise. In July, my son and I attempted to reach the summit of Mt. Kilimanjaro but had to turn back after when my O2 saturation had dropped to 60% at the halfway point. More recently, I've been getting tired more easily especially later in the afternoon. In June 2025, everything was in the normal range. But starting in June 2026, I've had 3 CBC with differential done; my RBCs, hemoglobin, and hematocrit have been gradually dropping. At my last test, RBCs had dropped to 2.98 M/uL, hemoglobin was 9.6 g/dL, and hematocrit was 29.1%, all of which are well below the normal range. My medical oncologist at Cleveland Clinc said that the numbers "could be" a result to the ADT therapy but wanted to rule out other factors and recommended additional tests including TSH, haptoglobulin, reticulocytes, LDH, B12, folate, iron, iron-binding, iron saturation, and a peripheral blood smear. Everything was normal except that reticulocytes were very high (suggesting that my body is trying to make more RBCs but they're getting destroyed or lost somehow) and the peripheral blood smear indicated some possible abnormalities. Note: I was taking supplements including iron, B12 and folate; the latter 2 were high normal. My PCP ordered referrals for gastroenterology for a possible GI bleed and to hematology for the blood abnormalities.

Hoping to get some resolution soon. Wishing us all the best.

@stragale Stragale, sounds like we are having similar side-effects from ADT: hot flashes, lower oxygen and RBC levels. I don't feel well most of the time due to weakness and also because I have GI issues (IBS) from radiation treatments in 2010 for my original PC diagnosis. Take care friend. ~Wayne