Hormone Progesterone in the treatment of anorexia as an appetite stimulating agent

[malihaamjed]

My father has started with Enzulatumide since 2 weeks after failing Docataxel. He feels a lot of fatigue throughout the day , the lymphedema has gotten worse and the rib mets are now palpable and painful. Also his appetite has gone down , but weight not affected. Doctor has recommended synthetic progesterone tablets to increase the appetite. I would like to know has anyone taken progesterone? I have read it's been used as a palliative treatment for breast and endometrial cancer.

Will it be useful for killing our cancer? Or will it worsen the side effects?

[pjoshea13]

I don't know what the biological fate of "synthetic progesterone" is, but progesterone itself can convert to testosterone:

... cholesterol->pregnenolone->progesterone->androstenedione->testosterone->etc.

This is a pathway that Zytiga targets.

There was a Norwegian paper in July that examined the role of progesterone in PCa cells [1]:

"This study aimed to examine the distribution of progesterone receptor isoforms (PGRA, PGRB) in PCa tissue and their association with clinical endpoints."

"... a high PGRB expression in tumor tissue was associated with an unfavorable prognosis in both univariate and multivariate analyses: Biochemical failure (HR: 2.0 ...) and clinical failure (HR: 2.5 ...)".

That's not to say that additional progesterone would have any impact on PCa cells. In fact, Zytiga probably increases progesterone levels, since it inhibits downstream conversion of progesterone.

...

"Megestrol Acetate (Megace®): Megace® is a progesterone, or steroid hormone, that improves appetite in patients with advanced cancer. Megace® is FDA-approved for the palliative treatment of advanced breast and endometrial cancer." [2]

From a 2013 paper [3]:

"There are concerns whether megestrol acetate (MA) stimulates the growth of prostate cancer in castration-resistant prostate cancer (CRPC). We evaluated the effect of cumulative doses of MA on the disease-specific survival (DSS) in patients with CRPC who were receiving Docetaxel-based chemotherapy."

"Cumulative doses of MA as adjuvant treatment for patients with CRPC and who are receiving docetaxel-based chemotherapy, did not affect their DSS. Therefore, MA can be safely administered in cachexic patients with CRPC."

-Patrick

[1] ncbi.nlm.nih.gov/pmc/articl...

[2] cancer.unm.edu/cancer/cance...

[3] ncbi.nlm.nih.gov/pubmed/236...

[Hirsch in reply to pjoshea13]

Excellent response. Thanks

[malihaamjed in reply to pjoshea13]

Very informative. Thank you

[Tall_Allen]

Enzalutamide blocks the androgen receptor, which progestins could otherwise activate in some types of castration resistance. Progestins suppress GnRH directly (much like Firmagon). So, if it has an effect on his cancer at all, it should be beneficial. In fact, a Megace patch is sometimes prescribed to help with hot flashes.

[malihaamjed in reply to Tall_Allen]

I'll talk this with the MO . He's already on lupron . Thanks

[AnnieAppleseed]

I suggest acupuncture. no real adverse effects and can help re balance the body.

[Hirsch in reply to AnnieAppleseed]

Not appropriate

[AnnieAppleseed in reply to Hirsch]

Why? Also medical cannabis if in a legal state. Known to enhance appetite.

[softwaremom00]

Would he consider cannabis oil ? If it is legal where you live it might help him get an appetite. Most places that allow Medical Marijuana will allow it for cancer patients. It is also supposed to help with pain. Just some food for thought. Hugs and Prayers for both of you. I hope he feels better soon!

[malihaamjed in reply to softwaremom00]

I hope too. Thanks

[HOPEFULSPOUSE]

My husband uses a topical progesterone - we get from Dr. John Lee's website - johnleemd.com/

His doctor recommends topicals as much as possible so my husband gets his vitamin D as a topical as well. Makes it much easier than swallowing a pill.

[malihaamjed in reply to HOPEFULSPOUSE]

That's great. Thanks

[tennis4life]

Hi Mali, I added progesterone to my regime in 2013, application directly to skin, 2x per day. I had a temporary decrease in PSA for about 4 months and then it began to rise again. Within a year or so the PSA level rose again to where my doubling time number (that had been established) would be expected to be (1.2 years). I had no side effects and couldn't say if it had an affect on appetite. My unscientific but personal experience is that it has no appreciable affect, positive or negative, on PC growth though it will temporarily decrease PSA level. My appetite is always good so I can't comment on that.

[malihaamjed in reply to tennis4life]

Thanks. Right now I'm more concerned with the unilateral lymphedema he has developed

[AnnieAppleseed in reply to malihaamjed]

There are massage therapists who specialize in LE. Go.online to lymphnet.net for national organization. They have lists of local practitioners. doesn't go away but can reduce and discomfort reduces.