It's been one year since Richard Wassersug got me started on tE2 gel and I am elated! My PSA is still decreasing...now down to 0.014 from 0.046 six months ago and ABSOLUTELY NO side effects other than the tiny boobs. If anyone is interested in trying the gel, it was available on Ebay...I don't know if you need a prescription. It should be available in Canada and Europe. I buy it here in Thailand without a prescription at a reasonable price; however, getting it to the States takes time and is fairly expensive. If you can't find it, PM me and I may be able to help you. I have been able to get a few tubes to my daughter in Illinois with friends who have visited me here and I have also sent a couple through the mail.
Ron Pitelka
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E2-Guy
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Since Estradiol (E2) is aromatized from testosterone (T), increasing one's E2 level results in lowering T levels. Exogenous oestrogens suppress LH production from the pituitary via negative feedback, lowering systemic testosterone production whilst avoiding the effects of a low oestrogenic state such as osteopenia and dysregulation of lipid and glucose metabolism. Oral systemic oestrogens were amongst the first successful systemic therapies for advanced prostate cancer; however, systemic oral oestrogens in men are associated with an increased risk of cardiovascular and thromboembolic disease resulting from a first‐pass effect in the liver with production of PROTHROMBOTIC proteins. Transdermal application of estradiol (tE2) avoids this effect and offers an alternative, potentially safer, means of androgen suppression with estrogens. tE2 has an efficacy similar to LHRH agonists such as Lupron without the nasty side effects.
Richard Wassersug, PhD is in Vancouver and has written numerous papers on this subject. He has also published two books on "Androgen Deprivation Therapy" (available on Amazon).
There is NO skin cream that will cure prostate cancer or lower your PSA score at all, in fact it will continue to go UPWARDS for as long as you go untreated properly by a legitimate doctor.
16starsky I've just read a couple of your previous posts. We're in the UK as well and my husband has just had chemo number 4 with a similar diagnosis. How is your husband doing now?
Hello, my husband is good thankyou.He finished his chemo in Jan, with very few side effects, (thank god) The OC was very pleased his PSA was 310, and lowest was 1.5, it had gone up to 2.00 last month, so im a bit concerned, hes on Lupron only, but is due to start 6 sessions of EBRT next week in Leeds. (one a week)
Im hoping the PSA will drop. What is your husband on ? How old his he and what was his PSA then and now ?
Totally stunned by this diagnosis, no real symptoms my husband is 62yrs, quite fit, cant think or don't want to think about the future.
The people on this site are a fountain of knowledge, to a novice like me, but im learning every day,
Hope your husband is doing well and if you want to ask me anymore about the chemo feel free ,
I apply it twice a day to my inner thighs and lower abdomen. "Oestrogel" is produced in France by 'BESINS'...I am in Thailand and I don't need a prescription to buy it here.
Sure it will be controversial. The current guidelines do not include it and the treatment is off-label. I doubt that you will find an oncologist that will recommend this.
You can just try it and observe your PSA value. Or wait a few years for the results of the STAMPEDE ARM L and then whether these results will cause a change in the guidelines.
I’ve been on Xgeva shots monthly shots since having a bone met in 2017. But in ‘18 I dropped down to quarterly. But I’m wondering if xgeva is necessary after stopping lhrha and switching to estradiol since the latter has shown to be more friendly to bones?
How long has it been since your last Lupron injection and when did you start using the patch? Have you had any recent bone scans/density tests performed? If you have been taking Xgeva shots concurrently with the E2 it will be difficult to determine which one (if either) is helping. Since E2 is necessary for bone health in both men and women, and one of the side effects from Lupron is bone density loss due to the T decrease, I would think that your bone condition should improve from the application of E2. I think that the only way of knowing if the E2 by itself is helping, would be to decrease or stop the Xgeva injections and have a bone scan performed or at least monitor your ALP levels. Prior to starting the tE2 regimen my ALP level was above the maximum level (which was an indication that something wasn't quite right in my bones) and shortly after starting on the E2 my ALP dropped down to well within the normal range.
Richard W., TA, and Patrick are the real authorities on this subject...I'm just a layman!
I stopped trelstar in June 2018, Psa lqincreased , found two bone mets by PSMA ga68 ctpet in October had them hit by sbrt in December , had bone density test in December ‘19 which was unremarkable ( also had one in Dec ‘18 which was unremarkable ) and went on estradiol January 19. My AP has always been normal. That’s why I’m thinking I may be able to stop xgeva.
What are your most recent blood stats...PSA, T, E2? Are you using only tE2 since January? If your PSA is 'relatively' low I would stop the Xgeva shots until you are scheduled for another bone scan.
See my profile. Psa .1, T 17, E2 45. I expect T to go down below 10 as I didn’t change patches for six days before last test: my bad. They wear off quickly.
Your PSA and T look good; however, you may be able to lower your PSA even more by increasing E2. You can see in my updates how my numbers changed as I started using a bit more tE2 gel. Since my last PSA was down to 0.004 and my T was at 10, I decided to reduce my tE2 applications slightly to see if I can still maintain an undetectable PSA.
It appears that at this time your bones are not showing signs of mets?
I’m feeling great except for a lower back problem I’m working out with rehab. I’ve got bad lumbar discs. I’m on a major weight loss program which I’m enjoying because my disgusting gut is beginning to disappear. I wish I could get rid of the man boobs too.
I’ve only had visible bone mets when I went on adt vacations and they were only visible with axumin or PSMA scans so strangely , under the traditional definition, I wouldn’t have been metastatic!
It’s easy to stay on the patches due to much less side effects than lhrh agonists which are just awful.
I’m hoping estradiol works for a very long time!! Not sure it’s worth it to try to get Psa lower than .1.
Happy to hear that the patches are working for you and that you are feeling good. The "visible bone mets" are understandable if you stop conventional ADT; however, unlike the E2, LHRH agonists decrease bone density. My bone density has actually increased since I started applying the E2 gel.
How much do the patches cost you per month? My gel here in Thailand is costing me about $10
...even after shipping it to the States the cost is about $30/month. Richard W. and I really like the transparent gel since it is so easy to apply, dries in a couple of minutes and causes no skin irritation. He has been on it for many years and has not become castrate resistant. DES was actually effective when men became CR from Lupron.
Regarding the boobs...I'm the envy of many a 'ladyboy' here in Thailand! This country is famous for its beautiful "Katoeys" (Thai word for shemale). We even have a 'go-go' joint here cleverly named "Katoeys 'Are' Us". Actually, I initially found out about the Oestrogel from a ladyboy...thank God for trannies, LOL! If you care to see some of them, PM me your email address and I will send you some pics.
TA recommends tamoxifen for suppressing the gynecomastia; however, I have been reluctant to try it still wondering if it may possibly interfere with the action of E2.
My share of the cost has averaged $80 per month for (32) .1 mg patches under my Medicare plan D for the last six months. The Gross cost is $327. But since I use six per week (not 8), it costs me $60 per month.
Very easy. You just apply some to the plastic scale included with each tube of gel and spread on your inner thighs and abdomen. It's like putting toothpaste on a brush. The scale tells you how many mg. of E2 you will receive by the length of the bead. Your blood test results should help you adjust the amount over time. I started with a fairly short bead and gradually increased it to get my T down to castrate level and my PSA to an undetectable level. Richard W. doesn't think that accurate bead consistency is necessary...sometimes you may apply a bit more and other times a bit less. He recommends getting E2 to levels well above the normal male high of about 45. My last one was 174 which he thought was very good. Some people on this forum have totally different opinions regarding E2 levels and feel that it should stay in the normal male range...somewhere between 20 and 30. From what I have read there appears to be some correlation between high E2 levels in men and PCa risk. If a man already has PCa, the negative effect of E2 can certainly be argued. DES did a pretty good job of delaying PCa progression and the patch/gel seem to be working for many men. I made a mistake in one of my previous replies to you...my last PSA was 0.004, not 0.014. The guys that are against the use of E2 are also claiming that very high T levels are working well for them...no one PCa treatment appears to work for all of us. After all of the years of cancer research, we still are using just upgrades of old shit...cutting stuff out, burning it, poisoning it, and prescribing expensive nasty drugs!
I’ve been using the estradiol patches instead of gel since I feel you get a more accurate dosage. Each patch supplies .1 mg of E2 per day . I started with four and after a month reduced to three. I also started with the weekly version and found them too large and easy to fill up with water when showering and then fall off. So I switched to the patches changed every 3-4 days (twice weekly) which are small and easier to apply.
I’m very satisfied with estradiol compared with an lhrha like Lupron due to less impact to bones and cardiovascular system , no joint pain etc. And of course they’re inexpensive. My PSA has gone down steadily and T is still low ( see my profile) . After the PATCH trial in the UK is completed, I hope Lupron and it’s ilk no longer are sold.
Question: How do you control the amount you apply when you use the gel in a tube? Isn’t there a lot of waste ? I do like the idea of smearing it on vs applying patches which leave a sticky residue which needs to be cleaned off.
I don’t think in matters but I use Sandoz transdermal patches .1 mg. Per 24 hours, changed twice weekly. I started with four and went to three after a month of successful results in terms of T and PSA levels. I started with weekly patches but found them to be too big and easy to fall off. So I switched to twice weekly patches which are much smaller and easier to use. I had been using one patch twice weekly for years to stop hot flashes so I was familiar with them. The dosage I use is similar to the PATCH trial. The only side effect is painful nipples which subsided after a month and enlarged breasts. I can live with them. Lots of guys my age 75 have tits!
My experience with E-2 patches was mixed. I used them for 3+ years and they worked to perfection lowering Testosterone and PSA to castrate levels with zero side-effects with the exception of horrific loss of memory. Because of the memory loss, 2 months ago I went back on Lupron and YES! my memory is coming back but Crap, so are my Hot Flashes. Treating PCa with estrogen is no scam, I have 2 well-known oncologists and they both approved of my decision to try them
Thank you Joe! I sent five tubes of gel to my daughter in the States to accommodate anyone who wants to try it. With the postage costs, I'm making nothing. I am not aware of any memory loss related to E2 usage; however, at my age, it's certainly not what it used to be! I memorize songs to try to keep my mind active...a couple of days ago I started memorizing "American Pie" which is 8-1/2 minutes long and I know every word today. But the funny thing is that I often forget what I did yesterday!
If anyone would like to check on me, I have been Dr. Thomas Ahlering's patient for 14 years at the University of California Irvine; also Dr. Robert Flanigan's patent at Loyola University Hospital in Maywood IL, and Dr. Myron Fine's patient at Baylor in Dallas, TX. I'm sure that 'Richard Wassersug' and 'Tall_Allen' will vouch for me
There are many articles about E2 and its effectiveness in controlling PCa on the Web...this is just one of them: ncbi.nlm.nih.gov/pmc/articl... in BMC Cancer. 2010; 10: 244.
Published online 2010 May 28. doi: 10.1186/1471-2407-10-244
PMCID: PMC2889894
PMID: 20509933
Estradiol suppresses tissue androgens and prostate cancer growth in castration resistant prostate cancer
Bruce Montgomery,corresponding author1 Peter S Nelson,4 Robert Vessella,2 Tom Kalhorn,3 David Hess,5 and Eva Corey 2
Author information Article notes Copyright and License information Disclaimer
This article has been cited by other articles in PMC.
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Abstract
Background
Estrogens suppress tumor growth in prostate cancer which progresses despite anorchid serum androgen levels, termed castration resistant prostate cancers (CRPC), although the mechanisms are unclear. We hypothesize that estrogen inhibits CRPC in anorchid animals by suppressing tumoral androgens, an effect independent of the estrogen receptor.
I don’t rely on E2 levels. I rely on T and PSA levels to determine that E2 is working the same as I did with Lupron but I monitor lipids , E2 , prolactin, AK etc. every two months.
Seriously? There’s a clinical trial called PATCHES going on in the UK. Supported by their health system not by pharmaceutical companies because there’s no profit in it for them to use a natural hormone. You’re not thinking clearly!
Hey ron I think you’re on th something. Makes some sense. Sorry so many are aggressive just because you give an opinion outside the box!!! As a former nurse ive never been a fan of most medications. Less is more has been my theory. But occasionally certain meds can be beneficial!
This discussion of transdermal estradiol for ADT has turned into one heck of a thread. Although I do not like to enter into debates on this website, it is indeed true that I have suggested to some patients, who have found the side effects of LHRH drugs like Lupron difficult, that they might consider transdermal estradiol as an alternative. I am NOT an MD, so patients should view this as just a suggestion for discussions with their MDs.
In North America this use of parenteral (=non-oral) estradiol is an off-label treatment for PCa. But, as others have noted, it is in a Phase III clinical trial in the UK. That is the PATCH study and has recently been rolled into the massive STAMPEDE clinical trials.
I do not have any investments in any estrogen products, transdermal or otherwise.
That said, there is a lot of data showing that high dose estrogens can be used for ADT. These data go back to the days when Charles Huggins introduced the synthetic estrogen DES as an alternative to orchiectomies for ADT. A review article on this topic, which I coauthored, is: Wibowo E, Schellhammer P, Wassersug RJ. 2011 Role of estrogen in normal male function: clinical implications for patients with prostate cancer on androgen deprivation therapy. J Urol. 2011 Jan;185(1):17-23.
Paul Schellhammer, MD is a prostate cancer patient, a prostate cancer researcher, and also the past president of the American Urological Association.
Huggins won the Nobel prize for his work on the influences of gonadal hormones on prostate cancer. However oral DES has a high risk of blood clots and this seem to be avoided by using the natural estrogen estradiol, administered through the skin. [The transdermal route avoids the first pass at the liver where clotting factors are produced.]
A search on the names Ruth Langley and Paul Abel plus the word "estrogen" in PubMed will bring up the peer reviewed medical literature supporting the PATCH trial. One can also go to clinical trials.gov to bring up the details on trial.
One of the thinks that interests me (and I have coauthored some of the relevant preclinical rat work on this) is that estradiol may elevate libido above the castrate level. A year or so ago the PATCH team, published some preliminary data showing this to be true within their study protocol. The reference is:
Gilbert DC, Duong T, Kynaston HG, Alhasso AA, Cafferty FH, Rosen SD, Kanaga-Sundaram S, Dixit S, Laniado M, Madaan S, Collins G, Pope A, Welland A, Nankivell M, Wassersug R, Parmar MK, Langley RE, Abel PD. 2017 Quality-of-life outcomes from the Prostate Adenocarcinoma: TransCutaneous Hormones (PATCH) trial evaluating luteinising hormone-releasing hormone agonists versus transdermal oestradiol for androgen suppression in advanced prostate cancer.
BJU Int. 2017 119(5):667-675.
Against all this background, I find it harsh and upsetting to see the bold assertion in this thread that transdermal estradiol is absolutely a scam, that it is snake oil. Somewhere in this thread someone even said that anyone discussing the transdermal estradiol option should be thrown off this site.
Whoever asserted that transdermal estradiol is absolutely a scam, could you please let us know how you reached that conclusion? Why are you so sure that anyone speaking on behalf of this option is a scammer?
If you feel that I should be thrown of this site, would you allow me to defend myself with a dozen so papers in the peer-reviewed, medical literature variously authored by Charles Huggins, Paul Schellhammer, Ruth Langley, and Paul Abel? Would you be willing to read the preclinical data that I have coauthored on the rat data showing that estradiol in androgen-deprived males can improve sleep quality, reduce daytime fatigue, and help preserve some libido?
An implication of the position you hold is that the PATCH study is a total waste of time and money and should never have been started in the first place. If you believe that, would you be willing to write the MD oncologist in London, England, who heads up the STAMPEDE trail to tell her that the PATCH study should be shutdown immediately? [I can send you her contact info.]
I am at a loss to understand where your confidence comes from for the claim that ronronHU, who has posted under his own name here, is a scammer. If he is, what is he scamming? He is selling nothing. So what are the data that led you to this extreme and absolutist conclusion that there is a scam here?
To be clear, as ronronHU and others in this thread have noted, transdermal estradiol (tE2) can be used as a form of ADT. Neither ronronHU nor anyone else in this thread has claimed that is a cure for prostate cancer.
The PATCH study is designed to see how well tE2 fairs in a head to head comparison with the LHRH drugs. Information on that trial is available for anyone to see at clinical trials.gov.
There is not a single MD behind this trial. Rather the research team involved in this clinical trial has about 50 people working on it. A couple of dozen MDs and scientist have published in the peer-review medical literature in the last decade or so on the both the case for the PATCH study and the results to date. None of them are selling anything. So why are you as convinced that this is a scam?
Rather than repeating the assertion that someone is a fraud and a scammer,could you PLEASE help us understand where you are coming from with such confidence. I mean this as a serious question: What data would you need to be convinced that no one is scamming anyone here and that transdermal estradiol as a form of ADT is worthy of the clinical trail that is testing it out right now?
Since I started on the tE2 regimen in April of 2018 I have been getting a PSA, E2, T, and ALP test every three months. I have previously posted those results...if you can't pull them up, I can send them to you. After my lymph node surgery in September of 2017 (which reduced my PSA by about 60%) my PSA continued to slowly rise to 0.71 which is when I started the tE2 regimen.
I am able to buy it in Thailand without a prescription; however, I don't think it is even available in the States. It was available on Amazon some time ago, but I don't think it is anymore. Check to see if it is available on Ebay and let me know if you find it and if you need a prescription. The mechanism of action is basically the same as the 'patch' which is also prescribed for women. I had recently talked to an OB-GYNE friend who told me she was having a difficult time finding it for her patients. It is produced in France by BESINS and should be readably available in Europe. Richard Wassersug is able to buy it in Canada, but very expensive...like $50/tube. I would like to help anyone interested in trying it; however, shipping it from Thailand to the States takes time and is fairly expensive. I recently sent a few tubes to my daughter in Chicago to give to a couple of friends who want to try it...let me check to see if she still has any.
I still don’t understand the dosage differences we’re taking . I’m following the patch trial formula administration regimine and you seem to be just smearing it on daily . Doesn’t this give you pause?
I am not familiar with 'patch' dosages...not sure how they compare with the gel. I started using a gel amount as suggested by Richard W. since he is the tE2 guru. Richard has been using this for many years and I know that he can answer any questions related to its use. He is also very familiar with ongoing patch studies/trials. DES was prescribed in daily 5 mg oral doses; however, recent research has hypothesized that 2 mg doses would have been equally effective. Initially I was applying an amount which should have been delivering about 2 mg of E2 daily into my bloodstream via my inner thighs and abdomen.
Since my T level was still well above castrate level and my E2 level still relatively low, I then divided a 'slightly' larger dosage into 'two' (1 morning & 1 nighttime) applications... I'm guessing about 1.5 mg each. My T continued to decrease, E2 continued to rise, and my PSA continued to decrease; however, my T never reached castrate level (<50). If you would like to discuss this with Richard or me, please send me a PM and I can call you or give you Richard's phone number. We are both happy to talk with anyone who has an interest in this regimen.
I talked to Richard. The patch trial required a T level of <50 before decreasing patches to 3 bi weekly from four. That’s what I used as basis for appropriate dosage. My T was <7 and Psa was declining so I knew it was working. He told me that he recognized the dilemma re: discrepancy in dosage between gel and patches. I think the gel is less reliable ( that is more variable) in terms of dosage because you’re smearing it on. I think patches are the way to go.
As long as my PSA continues to decrease or at least remains where it currently is, I will stay with the gel since it is so easy to use, dries within a couple of minutes, no skin rash, I can bathe/swim shorty after applying, and is relatively inexpensive. For 'me' being in Thailand with no insurance (Medicare doesn't pay for anything outside of the US) it is probably the best option.
Id try it if my T were high...Im a bit of a strange case....T levels below 1 ever since I started bical....so basically it would be more chance of things going wrong than soving a problem that doesnt exist....truly a case of if it aint broke...otherwise congrats on this boldly innovative treatment choice...hats off.
Thank you! I agree that there is probably nothing that E2 would do for you if your T is that low and I assume your PSA is also very low. However, estrogen therapy often worked when men became castrate resistant to LHRH agonists.
To tell you the truth when I started having 'pee problems' harkening back to my father who alleged suffered bph...but as I lately found out had a prostectomy and lived on merrily for ten years succumbing to unrelated complications...I had it in my mind I was low T with rising Estradiol...I actually may not have been far off in this wild assumption given my T nadir....must be close to a worlds record...to the point I was trearing my symptoms with anything that I believed would enhance my normal masculine vigour and crush this suspected 'feminization'. Good thing I finally sought medical help as things weren't exactly humming along....not to say that hyperphysiologic approach isn't worth examining closely...you mention a Vancouver doctor proponent...are you consulting with him collaboratively. He must be ecstatic with these amazing results...If your not out the box you ain't trying hard enough.
Richard Wassersug, PhD in Vancouver has been my mentor in this 'unconventional' regimen...he has been using it for ~15 years with great results. He had an RP about 19 years ago, experienced BCR, hated the side effects of Lupron and started using the tE2 gel. He currently has an undetectable PSA. Mine is also approaching an undetectable level. Needless to say, I am thrilled with my progress/results thus far.
Its complicated which implies many solutions to variable and variably variable consequences....PC is f'in dizzy stick whack a mole....while being pestered by a hornet swarm.
For people in the US or Canada, combination estriol+estradiol cream is easily purchased from iherb (and other online supplement stores) and Canadian customs won't confiscate it, but it is a lower dose.
Creams in higher potencies are available from Ona's Progesterone Cream (google it), she sells high dose estriol and estradiol creams (not in a combination cream), and Canadian customs won't seize that either.
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