Anemia related to hormonal ablation therapy for prostate cancer

Whether treatment consists of bilateral orchiectomy, LHRH agonist, antiandrogen therapy, or some combination of these, a mild normocytic anemia is common, with a decrease in hemoglobin levels of 1-2 g/dl after approximately 6 months. What remains unclear from the available data is the clinical sequelae of these findings, if any, and the differences between monotherapy and CAB in causing anemia. The guidelines for treating patients receiving hormonal therapy for prostate cancer are generally similar to those for any anemia related to any chronic disease. Blood transfusions and erythropoeitin can be considered. Continued studies are evaluating the role of hormonal strategies that are alternatives to standard CAB and, in particular, its relative effects on anemia. For instance, intermittent androgen ablation therapy may provide similar levels of prostate cancer control with fewer symptomatic complications (11). It is unknown whether one mechanism mediating this improvement is a decreased incidence of anemia.