Diagnosed wed late 2009 with Gleason 7 (3,4) and treated with concurrent HDT (Lupron) and IGRT. PSA nadir 0.8. I’m also certain that the Lupron treatment produced cognitive impairment as well as weight gain. After 3 years from th IGRT PSA rose to biochemical tecurrence and salvage brachiotherapy was performed. Brachytherapy induced stress incontinence which has slowly but not completely mended. PSA nadir of 1.2. After two years PSA has risen again to biochemical recurrence.
I don’t want to do Lupron again. I’m thinking estradiol patch might be best for me. Waiting for PSA to rise to the 7-10 level before considering any treatment and in the interim interviewing oncologists and trying to keep my blood pressure and testosterone down with spironolactone.
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kreg001
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Estradiol patches have been used in place of Lupron ,perhaps if your title said estradiol patch Dr Wassursug would respond, he is very familiar with using estradiol to reduce T in PC. The studies to look for are the Ockrim studies on google scholar. scholar.google.com/scholar?... There are other studies by Ockrim, and also studies by TM Beer in Portland OR. When I did it I used 6 .1mg patch prepped with alchol around stomach one patch every day 6 out of 7 days. When doing this it is important to have your estradiol level measured when you do labs. I think Dr W used an estradiol cream every morning If you do it I prefered the climera patches made by 3M they are small and have very good glue, Dr Myers liked vivelle dot , Whatever you do do not settle for the generic Mylan patches, they are big cumbersome and the glue does not stick well.
I just talked with Richard Wassursug on 4/15/2018 and his PSA is undetectable using only 'Oestrogel'. I just started using it and will share my findings when I get my next PSA in about a month; however, that may not be enough time to show much of anything (especially since I am starting with only .75 mg and will gradually increase to 1.5 over the next month.
My Gleason was 4+4=8, and I opted for early aggressive intervention, (which is increasingly recommended to improve outcomes): radiotherapy and brachytherapy, as well as triple blockade ADT (Lupron, Casodex and Avodart). I switched from Lupron to Zoladex, hoping my severe allergic reaction to the LHRH shot would go away. It didn't. I switched to Trelstar, and initially, there was no problem. After the second injection of it recently, the allergy has started again, although not as severe....yet. I also believe the LHRH causes cognitive impairment. It's frustrating to have memory and other cognitive issues, and the weight gain, since so many people who know me make negative comments, seemingly critical of my forgetfulness and occasional social mis-steps. it seems the change in me is that noticeable to others, who I assume would rather I would return to my normal level of functioning. My 18 months of ADT is finished in 6 months or so, and we shall see how my PSA and testosterone levels fare after that. A note about the Estradot patch: Many guys develop gynecomastia, which, although reversible with surgery, is another hassle to bear.
I believe you can get some sort of radiation before Lupron to avoid man boobs. I got man boobs as my only side effect from Lupron and I definitely don't want them again! I took a short Lupron vacation and they went away. The vacation is probably over.
I was made aware of the option to have radiation first to prevent man boobs, but was told it might be safer to have surgery afterwards instead, if necessary.
I think proper diet and a commitment to exercise may be the best way to prevent gynamastia ,and weight gain from any form of adt.That said I had radiation prior to starting estradiol patches, It was a one time thing, and turned out to be no big deal, I do not like surgery, and avoid it if possible. That said transdermal estrogen worked well for me , I rechallenged with it 4 times and got a response. Some on this list claim that estrogen is also bad for prostate Cancer, though for many years it was the only therapy. I do not know who is right. It protects the bones, has cognitive benifits and transdermal unlike older oral estrogens bypasses the liver and does not have the blood clotting issue of oral estrogens. Beleive it or not as a testosterone deprived man it felt good to have some hormone in the body, as My freind Ludwick RIP said “It was the only time in my life I could win an argument with my wife. The treatment for this disease certainly has some cruel side effects, but worth it if it keeps you alive. During ADT everyone says “but you look so good” When you do chemo and your hair falls out you see people looking at you, and now they know you have cancer. Wear it like a badge of courage!
I just talked with Richard Wassursug on 4/15/2018 and his PSA is undetectable using only 'Oestrogel'. I just started using it and will share my findings when I get my next PSA in about a month; however, that may not be enough time to show much of anything (especially since I am starting with only .75 mg and will gradually increase to 1.5 over the next month.
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