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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2004Anemia Associated With Androgen Deprivation
I got a call today from our GP as a follow up to routine blood work, sugar, cholesterol, liver enzymes all fine but she said that I'm anemic and went on to say this can be caused by any cancer and recommended a colonoscopy to rule out any problem there.After going through the Pca routine I'll certainly follow her advice. I vaguely remembered seeing something relating anemia to Lupron a while ago, with a little effort I found an interesting article by Dr. Strum et al: at http://www.prostate-cancer.org/education/sidefx/Strum_Anemia.html I'm curious as to whether anyone here has had any experience with Lupron/ Zoladex and anemia. Tom > I got a call today from our GP as a follow up to routine blood work, sugar, > cholesterol, liver enzymes all fine but she said that I'm anemic and went on [quoted text clipped - 10 lines] > > Tom I surely wouldn't be interested in such a bothersome procedure unless stool specimens have indicated gastrointestinal bleeding. If stool specimens are negative the anemia is obviously not due to anything colonic. Larry > > I got a call today from our GP as a follow up to routine blood work, sugar, > > cholesterol, liver enzymes all fine but she said that I'm anemic and went on [quoted text clipped - 6 lines] > specimens are negative the anemia is obviously not due to anything > colonic. It is indeed bothersome, but stool samples are less accurate. I read an article about this once that claimed the fecal occult blood test (stool samples) had about a 70% success rate in discovering colon cancer. If I remember correctly, sigmoidoscopy had a 90% chance of finding a cancer if it was present, and colonoscopy was higher still, though I don't remember the number. For a healthy person with no reason to suspect cancer, using the stool sample test is a cheap, non-invasive test. It's the one I always chose instead when doctors recommended a routine colonoscopy or sigmoidoscopy. However if there is some basis of suspicion, then a clear colonoscopy gives you more peace of mind than a clear fecal occult blood test can. Alan > > In article <zusTc.450$de4.250@trndny07>, "Tom C" > <thomcu@verizon.net> [quoted text clipped - 36 lines] > > Alan OK, but this is about the most unusual approach to the diagnosis of anemia I have run across in my thirty-five years of internal medicine practice. Larry Don't doctors like to do a colonoscopy once you reach a certain age, anyway? And then every five years after that? Personally I think the little camera "pill" is a much better idea. Why don't they use that more? Cost???? Bev > > > In article <zusTc.450$de4.250@trndny07>, "Tom C" > > <thomcu@verizon.net> [quoted text clipped - 41 lines] > practice. > Larry Bev, I believe you're correct, when I told the Dr. I had never had a colonoscopy at 62, she seemed a little surprised and subsequently recommended one. Like most of us here I've been stuck, probed, injected, catherized and had pictures taken that don't fit in the family album, what's one more test. There is no modesty left ;-)) Tom > Don't doctors like to do a colonoscopy once you reach a certain age, anyway? > And then every five years after that? [quoted text clipped - 48 lines] > > practice. > > Larry > Don't doctors like to do a colonoscopy once you reach a certain age, anyway? > And then every five years after that? > > Personally I think the little camera "pill" is a much better idea. Why don't > they use that more? Cost???? > Bev Bev, you are absolutely correct. Doctors recommend that after age (x) one should have colonoscopy every (y) years. This is part of an excellent general health program. If there are symptoms of any type of gastrointestinal disease, particularly involving change in bowel habits, a colonoscopy is essential. The point that I spoke to had to do with the workup of anemia, which puts us in a completely different clinical situation. If anemia is of a type consistent with blood loss; that is, if it is microcytic (red cells small, low MCV, Mean Corpuscular Volume) and hypochromic (red cells low in hemoglobin, low MCHC, Mean Corpuscular Hemoglobin Concentration), you then must look to the gastrointestinal tract as your first suspect. If you are losing enough blood into the gut from ulcer or cancer or inflammatory disease to cause anemia, there will be detectable blood in the gut. If there is not, colonoscopy might be worthwhile as the general evaluation measure I mention, but would be a very strange first maneuver of investigation of the anemia. Larry Larry, At this point I believe that what my Dr. stated is that my hemoglobin is low I would like to think that this is consistent with what Strum stated in the article I referenced in my original post, however, I'm not qualified to second guess a physician, this does not mean I rule out another opinion. I appreciate your thoughts. Tom > > Don't doctors like to do a colonoscopy once you reach a certain age, anyway? > > And then every five years after that? [quoted text clipped - 21 lines] > of investigation of the anemia. > Larry > Larry, > [quoted text clipped - 34 lines] > > of investigation of the anemia. > > Larry I had one blood test about a year and a half ago which was between my bout with pericarditis and finding Pca which showed I was anemic, but a few weeks later it tested ok. I wonder what that was about. I'm going in for another general physical this week. I'll be interested in seeing what the blood test shows. Interesting discussion. Dale j  SignatureEmail: dalej2@mac.com I agree that it is odd to attack anemia with a "let's do a colonoscopy". But if this person has never had one, or had a history of digestive problems, or maybe something had shown up pointing in that direction then maybe it would be just as good as time as any to do one. Just a thought. Bev > > Don't doctors like to do a colonoscopy once you reach a certain age, anyway? > > And then every five years after that? [quoted text clipped - 21 lines] > of investigation of the anemia. > Larry > > > In article <zusTc.450$de4.250@trndny07>, "Tom C" > > <thomcu@verizon.net> [quoted text clipped - 7 lines] > > colonoscopy to > > > > rule out any problem there.After going through the Pca routine > > > > ... > > > I surely wouldn't be interested in such a bothersome procedure [quoted text clipped - 9 lines] > anemia I have run across in my thirty-five years of internal medicine > practice. Aha. You're not questioning whether colonoscopy is more accurate than the stool sample in diagnosing colon cancer, you're questioning whether it makes sense to even look for colon cancer as the cause of anemia in the absence of any other symptoms or indications. I misinterpreted your earlier posting. Now I understand. Please excuse my digression in the wrong direction. Alan > Aha. You're not questioning whether colonoscopy is > more accurate than the stool sample in diagnosing colon [quoted text clipped - 7 lines] > > Alan Thank you, Alan. My initial posting was focused on what I thought was a question dealing exclusively with anemia and its cause and evaluation. Larry |
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