Thinking of estrogen patches as an alternative to ADT, some here report success with less side effects.
But BAT seems to work better if done from beginning. I know Patrick pjoshea13 is doing BAT with DES. But not sure how to get access to DES from here and patches seems to have less issues with CVD.
If on BAT with estrogen patches: do you stop patches during off phase or just get the T injection? What is your protocol?
I have been using tE2 (transdermal Estradiol) 'gel'...basically the same concept as the "Patch" for 16 months now with great results. My motivation for this type of ADT goes back to my readings of every article that I could find on the old, synthetic oral estrogen DES (Diethylstilbestrol) that men inflicted with PCa had taken for about 25 years until it was replaced with Lupron in the mid 80s. My father and his two brothers did very well for years on DES with few of the nasty side effects associated with 'newer' ADT drugs. Richard Wassersug, PhD has been my mentor in this experiment. I have previously posted my results using this regimen.
An informative read: ncbi.nlm.nih.gov/pmc/articl...
I’ve been on estradiol patches since January after five years of intermittent ADT. I did it to avoid the side effects as I’m still castrate sensitive. See my profile. I also talked to Dr Wassersug. No need for BAT as patches work very well.
What do you feel are the differences in side effects between ADT and estrogen patches?
Less fatigue, more strength, no joint pain , no hot flushes, less risk of osteoporosis, less risks of cardiovascular events, much cheaper. I plan to stay on patches until they no longer work as measured by Testosterone rising above 20 and PSA rising above 2.0. If that happens I’ll get a scan to locate the tumor and decide whether I should radiate it with SBRT ( assuming it’s safe to do) and/or add Zytiga to the patches or go back on Lupron.
why do you think less risk of cardiovascular events?
See attached . My error. CV events are about the same with patches as with lhrh agonists but other side effects are less. ncbi.nlm.nih.gov/pmc/articl...
I'm trying to figure out a similar approach. I was thinking perhaps estrogen patches cycled with Supraphysiologic t cycled with casodex/dutasteride. Estrogen was great for me BUT my libido was zero and I had a lot of strength/muscle loss. So far caso/duta is better - at least from the libido and muscle areas. Libido is nonzero but not very good. Muscle and strength are progressing at almost an alarming rate. If everything stays the way it is then perhaps I won't mess with the supra T. I'm up in the air about it.
keep me updated, thanks!
I finished the estrogen patch ADT. Worked well. T was undetectable. Then 2 years of high T (cypionate 400 mg/wk). Now BAT with low-dose estrogen patch for E replacement. I'm toying with using Relugolix to get endogenous T out of the way. I'm using Androgel for high T. 6 pumps of 1.82% gel supply 5 g of gel per pump gets my T to 1800 ng/dl.
I still haven't decided.
1. Perhaps T every 28 days and estrogen therapy continuously. Perhaps dutasteride for first 2 weeks of the month. Long half life so no real reason to go off it other than to reduce any side effects.
Arimidex 1.5mg first week. Ramp down to zero by end of the 28 days.
2. Perhaps T every 7 days for 1-2 months and then estrogen therapy for 2 months. Perhaps dutasteride until last month. Long half life so no real reason to go off it other than to reduce any side effects. Arimdex 1mg while on T.
Very different profiles though.
1. Hi T for 4-5 days and then almost zero the rest of the month.
2. Hi T 1-2 months. Decaying for a month and then low/castrate for a month.
I like #2 from a libido/muscle/rbc/QOL standpoint. But which is better for the cancer?
If I can't make up my mind I'll go with #2 
Unfortunately neither of my main docs know much about BAT.
I am leaning towards #2. I just discussed with one of my docs and he made a good point. After a month of exogenous high t your body pretty much shuts down endogenous t. So should go to zero rapidly.
(I don't like the thought of estrogen and t at the same time)
Final report on BAT after 20 months
PSA rising on BAT
Update on starting Estradiol Patches for RT ADT
are transdermal estrogen patches going to be a thing?
Does anyone see a doctor who is well-versed and experienced with managing BAT treatments?
