MD Anderson

[Ran2599dy]

Does anyone know MD Anderson's recommendations on the use of low dosage Estradiol patches to help reduce bone loss and/or cardiovascular problems associated with long term ADT use?

[pjoshea13]

The solution that has been discussed in the past is the 0.025 mg/day Vivelle-Dot® (estradiol transdermal system).

IMO, the target for estradiol [E2] should be ~20 pg/mL, but it's essential that E2 not linger below 12 pg/mL.

LEF warns against E2 >30 pg/mL. The patch could be used less frequently than daily to avoid this.

-Patrick

[Ran2599dy in reply to pjoshea13]

Thanks, have read your passed post. They have been very helpful.

In the near future I am scheduled to have a conference call with MD Anderson doctors about the use of Estradiol in PC patients to help mitigate effects of ADT and bone loss. My MO in Kokomo, IN is not convinced I need it because it is not part of the standard of care. My MO wants hear what MD Anderson has to say. I have done a lot of research on the subject and can't find any good class 3 research studies on the subject.

[Ran2599dy in reply to pjoshea13]

The following is a good overview (use of Estradiol in PC patients)

erc.bioscientifica.com/view...

Estradiol for the mitigation of adverse effects of androgen deprivation therapy

[pjoshea13 in reply to Ran2599dy]

Thanks - very useful. -Patrick

[Tall_Allen]

I have no idea what MDAnderson thinks. These were the early quality of life results:

onlinelibrary.wiley.com/doi...

I would discuss taking tamoxifen 10 mg/day with it.

[Ran2599dy in reply to Tall_Allen]

Thanks

[abmicro]

Nobrainer. It helps with all of that. Rather than run a 0.05 patch, cut a 0.1 patch in half--economical and less of a rash if your skin is sensitive. I was instructed to take a coated baby aspirin to help with cardiovascular risks, but opinions vary on estrodiol if it helps or hurts cardiovascular. I think it helps. My old Dr Myers said it helps, but baby aspirin is insurance.

[donits in reply to abmicro]

Hi Abmicro,

I remember from your earlier post that you take Celecoxib 200mg and a small dose of aspirin. Don`t you think these two drugs don`t match? I know many patients are taking Celecoxib to slow the development of prostate cancer, but they don`t take aspirin, only other drugs and supplements.

Recently, I found info on Google that atorvastatin with celecoxib are more effective against cancer. What you think about it?

[abmicro in reply to donits]

That is why I changed to a coated baby aspirin. I also take Crestor for my statin. Coated is safer and reduces risk of stomach bleeding.

The blood thinning effect aspirin is required because I have an aneurysm in my aorta must not get any bigger. It is dangerous if it gets bigger. Aneurysm was caused by a hole "ASD" that was there since a child. The unequal pressures over my lifetime caused that aneurysm. Hole got worse with age until I started having symptoms in 2010. Not detected until Dr Charles E Myers ordered a set of scans from Sand Lake Imaging in Florida in 2011 to find cancer spots. The 32 page report by 3 excellent doctors detected the Aneurysm and other problems, including the cancer spot I was looking for. (Compare that to the 3 page reports I got from Kaiser when they outsource all scan readings to doctors in India to save money.) Report said to follow up which I did, and a Kaiser tech saw the hole on a ECO ultrasound. Said it was one of the biggest holes he had seen.

Kaiser Sunset Dr Salem, who does nothing but holes, plugged it. The plug stopped my dizziness. irregular heart beat, enlarged heart, and fatigue. Aneurysm stopped getting bigger and arrhythmia was resolved. Heart actually got a little smaller after that and Kaiser Dr who followed me up said I had an amazing response to the plug. Dr Charles E Myers saved my life with that scan and report. If that aneurysm was left undetected, would have died just like that young actor John Ritter of 3 is company. Chalk up another life saved by Dr Myers. Dr Myers deserves sainthood.

[Ran2599dy in reply to abmicro]

Thanks for posting your history. I too was a patient of Dr. Myers for ten year. He also sent me to Sand Lake to find my PC.

[donits in reply to abmicro]

Hi Abmicro

Thank you for all information. Your story is not easy but I firmly believe that all drugs and supplements will allow you to survive.

Best wishes, take care.

[monte1111 in reply to abmicro]

3 page report from Kaiser? I'm lucky to get 3 paragraphs. Once it was one paragraph. I remember thinking the guy must have been in a hurry to get to coffee break. Course the 3 paragraph report went into detail about all the non cancer issues I was completely unaware of and concluded I was falling apart. What a world, what a world.

[abmicro in reply to monte1111]

1. Kaiser gave me radiation burns to rectum that are just now showing up today in the form of rectal bleeding. Radiation was in 2005. They did not have to zap that area, only the one side of the pubic bone that lit up on the scans ordered by Dr Charles E Myers.

2. Kaiser did not consider that my fracture of the sacrum was from Fossamax use, and gave me a wasted radiation treatment to sacrum.

3. Kaiser trashed my biopsy samples of the prostate after 10 years. I needed it for possible clinical trials at year 15. Kaiser policy is to trash them after 10 years and does not warn you in advance.

4. Some of the advice from doctors I interviewed to get opinions were like they had zero experience treating cancer. Never again Kaiser. Happy with my PPO and various university specialists.

[Hidden]

My dr. at MD never mentioned it to me. I’ve had a bone scan and have osteopenia that I sent to him and he had no response. He’s not worried I’d guess.

[abmicro in reply to Hidden]

Not surprised. I am NOT a fan of MD Anderson. Got bad advice from them one time and ended up with Jaundice from an over prescribed dose of Ketoconazale. Should have started with half the dose and cut out all herbal shakes. No warning from MD Anderson. Dr Myers fixed me up by prescribing URSODIOL for 2 months to let my liver get better, and restarted me at half the dose with UROSODIOL checking my liver weekly.

[Hidden in reply to abmicro]

Not saying I didn’t get good advise when I was there but they only respond to things they feel are important.