Dutasteride and Tamoxifen (T->DHT blo... - Advanced Prostate...

Advanced Prostate Cancer
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Dutasteride and Tamoxifen (T->DHT blocker and SERM)

RSH1
RSH1

Are these contraindicated? I have prostate cancer and am doing cycles of casodex/dutasteride/zytiga, then estrogen patches/zytiga, then testosterone injections/dutasteride.

Should Tamoxifen only be used during the estrogen patch/zytiga portion of the cycle?

Thanks

18 Replies
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Not familiar with Tamoxifen, but recently found this: consultqd.clevelandclinic.o...

"Pairing abiraterone with the enzyme inhibitor dutasteride modifies abiraterone’s metabolic conversion, blocking production of 5α-abi while aiding accumulation of D4A."

In a nutshell, the metabolite D4A blocks T receptors, while the metabolite 5a-abi *activates* T receptors. Differences in drug metabolism may partly explain why it works so well for some men, and not at all for others.

I spoke with my MO at Cleveland Clinic, Dr. Ornstein about this information and he did not start me on dutasteride... He was aware of the study and Dr Sharifi...

There is a study by Taplin below:

clincancerres.aacrjournals....

ascopubs.org/doi/abs/10.120...

I do not believe there is conclusive proof at this time of benefit using Dutasteride with Abiraterone...

Keep running and putting out your blog...Gonna do a Zero 5 K this weekend...

All the best,

Don Pescado

RSH1
RSH1 in reply to NPfisherman

Thanks. The bicalutamide (casodex) and dutasteride (avodart) combo is a conventional treatment and has some evidence behind it. My oncologist was okay with it after I told her that I'd monitor my PSA every month. Zytiga mades sense to me and my oncologist wanted me to continue it. But I'll ask her next time I see her.

Glad to hear about the Zero 5K, that's awesome! I look at Dutasteride as something that one might try when PSA is slowly inching up on Zytiga, with a cooperative oncologist of course.

Good luck with that cooperative Oncologist idea.... mine says stick to the plan....exercise all I want, but was not in favor of SBRT for oligometastatic disease then, although his opinion has changed on that matter...too many positive results....

All the best,

Don Pescado

Hi Gecko,

I do not know that I would use estrogen and an estrogen agonist/antagonist (Tamoxifen) at the same time...

theoncologist.alphamedpress...

My advice is to message pjoshea13 or Nalakrats on your strategy as they are both up on hormonal therapies and have followed Friedman longer than I have been. I wish you luck on this strategy.

Don Pescado

RSH1
RSH1 in reply to NPfisherman

Do you think that tam with the estrogen therapy would perhaps be ineffective at getting testosterone down?

And I keep working on my blog - I'm happy that someone is interested in it since I really want to help people! I have the PrC and of course it's a drag but I'm trying to find the positives to having it. And I'm doing lots of blood sugar spike experiments now - they take a while and I can only do a few each week but have at least 20 or so to complete but this weekend will update the blog post with some more data. I'm getting a CGM (continuous glucose monitor) this week and it will hopefully help me with the finger sticks and also might give me more info.

NPfisherman
NPfisherman in reply to RSH1

Phillip Zaccarias posted on using the Freestyle Libre for BGM....I just got one and will pick up the meters today....my insurance covered....he lost weight and got is blood sugar down-- hope to do the same....

Good luck,

Don Pescado

RSH1
RSH1 in reply to NPfisherman

I chose the freestyle also. My insurance is terrible so I'm paying out of pocket with goodrx coupons. Total is about $220 for a reader and 2 2-week sensors. I'm so looking forward to getting it.

Thanks for all of your input and best of luck!

Cheers, Russ

NPfisherman
NPfisherman in reply to RSH1

Hope it helps... I am planning to use it to control my BS better since I use zytiga and Prednisone...my HgBA1C has been 5.4 for 10 months but could be lower...without Berberine, it would be higher I am sure...

Take care,

Fish

RSH1
RSH1 in reply to NPfisherman

My Hba1c is 5.3. Could be lower. I take berb and metformin and exercise 5-8 hours a week. Still on the high side. Prednisone is always prescribed with zytiga. One of my questions (have to ask my oncologist), is whether it's main purpose is to increase cortisol. And that begs the question of whether I can just monitor the cortisol and perhaps reduce the prednisone dose. Even if cortisol is just a proxy or is correlated with other corticosteroid actions of pred, it seems that I could monitor cort. But I'm not sure if that is all it does. Need to ask my oncologist.

RSH1
RSH1 in reply to NPfisherman

Oh, I also talked to pjosh and nalakrats. Pjosh was very helpful. Nalakrats is taking a break but directed me to pjosh.

NPfisherman
NPfisherman in reply to RSH1

Great...

Don Pescado

WebMD shows no interactions between the two

Dutasteride Lawsuit Side Effects: High-Grade Prostate Cancer, Male Breast Cancer. Dutasteride use may increase High-Grade Prostate Cancer and Male Breast Cancer Risk Dutasteride, sold under the brand names Avodart and Jalyn, and used to treat an enlarged prostate has been associated with an increased risk of developing high-grade prostate cancer.

RSH1
RSH1 in reply to Parscore

I have high grade prostate cancer and dutasteride is standard of care. I'll look at the study though. In general, preventing cancer sometimes requires opposite approaches than treating it.

I don't give medical advise, what do I know. I just ran across that and passed it on. Good luck as we hope to have...

RSH1
RSH1 in reply to Parscore

Thanks. I read it and found it helpful. Good luck!

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