Advanced Prostate Cancer
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Estradiol Levels In Men on ADT

Some here like myself, believe that the Estrogen metabolic pathway, that goes to 2-hydroxy Estrogen, and Estradiol---that the Estradiol should be blocked with an anti-aromatase enzyme. Some here use arimidex, to keep Estradiol down. Others use patches to overcome the side affects of ADT, which I am not a proponent of.

I just had my first Estradiol Blood test with my regular monthly PSA. Happy to report that the PSA, remains undetectable.

My Estradiol, was 20.3, just a hair under low normal for a 73 year old. Those that are keeping their Estradiol in Check, can you report what numbers you shoot for. Not interested in arguing about using with patches, just looking for those who shoot for low numbers, as to Estradiol.

Nalakrats

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Just a quick question . Do tou think your Estradiol l levels would be higher if you weren't taking DIM ? We're your levels ever check,prior to your utilization Of DIM ? Thanks

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I think they would be higher---I took it and continue to take it, without a starting E2 test. Shame on me. Dim is a definite anti aromatase Molecule. Arimidex, the drug would work faster and lower the E2 better, but I am trying to do it with DIM. Meeting with Doc. today--will discuss. I do not think my Uro. Doc. is very up on Estradiol, and Pca cell receptors for E2---He is not my Oncologist. See him in June.

He does write scripts for Arimidex---so maybe there is something in his skull.

Nalakrats

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Thanks . My oncologist at Sloan in NYC is not on board with many of the supplements I take and other meds like Avodart , Metformin I have inquired about taking . He is a world class researcher where I have given him references and he thinks the studies are very poor in their designs and conclusions for efficacy .

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Understood---and I have seen perfectly designed studies, that were 100% to be true, fail a miserable death---and with added embarrassment.

Nalakrats

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I am looking for a good oncologist at Sloan in NYC, can you tell me his name so perhaps I could see him?

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The procedure at Sloan (Sidney Kimmel Center for urological and prostate cancers ) is you call the below number and They assign you an oncologist - I don't believe you can request one particular oncologist . My oncologist's name is Dr Yu Chen . The Number to call at Sloan is 646-497-9068 . Good Luck !

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Thanks , so u just got lucky re dr Chen

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I am looking for a good oncologist at Sloan in NYC, can you tell me his name so perhaps I could see him?

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Do u think or know if all MOs at MSK feel that way about metformin et al? So did you stop taking those meds?

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Nal,

on 3 arimidex a week my estradiol is 7

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Thanks that was what I was looking for----what Dose, and which one of your Docs. recommended Arimidex, or did you do this on your own.

My Estradiol yesterday was 20, bur still I am undetectable on my PSA.

Patrick thinks 20 is borderline, and should be lower, as to E2. My Doc. said if i want he will write a script.

Also got a script today to do the CTC blood test, to count how many cancer cells are in my blood. Will be fishing tomorrow, I am packing right now, Gator is on a leash--and we are looking for shark.

Gator blood will be packed on ice.

Nalakrats

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Nal,

three 1mg tabs per week...got script from Uro based on what Myers rec when taking Avodart

Gus

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Gus,

NO-No-No! The Arimidex dose for men is half of a 1 mg pill at 3/week. You will end up in a wheelchair.

-Patrick

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Gus,

Way too low. Bone integrity will suffer. Go no lower than 12.

-Patrick

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Gus---I did some checking, at the beach now--Patrick is right---the sweet spot seems to be between 13-15.

Nalakrats

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Nal,

yes I know...also I tried the DIM brand you are taking in the past when the estradiol was 30 over several months with testing and it did had no effect so I went with arimidex...I am dropping the dose to 2 1mg per week and will retest in about 60 days

Gus

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Understood, the effect on women is a bit better than men. When talking to Dr, Zeligs the Uro, who developed this form of DIM--he though I might have to go as high as 5 Capsules a day. I said to him that was expensive--He suggested, to add Broccoli, Sauerkraut, cabbage, and Brussel spouts to my diet, as these contain Natural DIM.

I may add one tab of Arimidex/week---as I am at 20 as to the Estradiol--want to go to 15.

Nalakrats

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Patrick,

Yes I know got to low. I am going to try 2 1mg tabs per week then retest..got a ton of the 1 mg and they are not scored

Gus

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Gus, use a Gator tooth and cut in half.

Nalakrats

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Nal,

I am going to catch a Gator this weekend will use a Gator tooth to cut Arimidex tabs after I eat his liver

Gus

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Gus,

I have a pill cutter. Not ideal for such a small pill, but Arimidex seems not to come in 0.5 mg pills.

-Patrick

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1 mg every 5 days approximates to 1.5 mg every 7 days.

Or have a repeated 2-week cycle, such as:

Mon. - Sat. - Thu.

= 3 mg every 14 days.

-Patrick

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Patrick,

I started out with 1 mg a week with basically no effect...3 mg a week too much....so I will try 2 mg a week..shooting for estradiol 12 like your rec..just bought LEF Male Panel...will test in 2 months

Gus

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Hi - I am trying to catch up re this view, am I correct you are using the testosterone-estriadol model for Pca? That's why you are concerned with levels of E2 , aromatese, bcl-2, mAr, iAR, etc? Its the local estriadol you are worried about ,correct?, and I assume you have taken body identical testosterone to bring it to young adult levels?

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With your PSA undetectable, I would surprised if you had any CTC. Am I right?

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Not so. Having an undetectable with micro-metastatic Prostate Cancer, only means the circulating cells are dormant, or sleeping, as they circulate--What is left after the ADT initial attack that got me to undetectable is still there. Then there are the refractive Pca cells that do not give off the PSA enzyme/protein.

So the plan is to know what is left circulating--they can be measured.

Nalakrats

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What CTC test do u use , I have been using the Guardant360 blood draw genetic test?

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CellSearch---go to CellSearch.com---to read about it. Test Is performed by Quest Diagnostics

Nalakrats

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Wish I could help but 150 mg of casodex is driving my gynomastia thru the roof and likely the esttadiol. Got some flack from my onc for the test. Didn't press this time because l'm not sure what its effec on the cancer is. Meantime doing incline sit ups and losing wt. to see if I can get six pack abs to show or at leeast a few for a 78 yr old. Also the chest presses near my own body wt. My motto has alway been in the 17 1/2 yrs of fighting this darn disease is: If I have to go down I'm going down in a good ship. any comments on the above welcomed. The best to all.

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Try arimidex 2 1mg tabs per week

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There is plenty of evidence, that at T goes to DHT, in the Metabolic elimination process the body goes thru, that the DHT, will form a certain amount of Estradiol, as the DHT goes thru the completion of the Metabolic process. DHT will go to 3 Estrogen By-Products--and the one that is harmful is Estradiol, which it is well known that Pca cells have receptors specifically for Estradiol, as it does, for T and DHT. My thoughts are to keep all 3 down--but leaving enough Estradiol, so the bones do not crumble.

Nalakrats

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