Has anyone heard a preference for Arimidex or Tamoxifen for man boobs?

[George71]

Anyone been on either one for a time -- is it working -- does it shrink them if they start growing? etc

[noahware]

The Tamoxifen 10mg seems to be working for me, prevention wise. I do recall reading that it has been reported a bit more reliable than either Arimidex or radiation.

[George71 in reply to noahware]

Thanks noahware

[Tall_Allen]

Don't use Arimidex - only use tamoxifen.

nature.com/articles/4500782

sciencedirect.com/science/a...

[George71 in reply to Tall_Allen]

thanks T/A - I will check the links out

[George71 in reply to Tall_Allen]

unfortunately Arimidex is what I was prescribed -- i will have to ask him to change it -- thanks

[George71 in reply to Tall_Allen]

T/A,

I was engaged in another discussion -- I want to ask your opinion --to see if the following statement is generally true and if not what is your understanding of the matter? thanks

"bicalutamide does in effect deprive you of testosterone... for all practical purposes ... testosterone just circulates in the blood but can not be used by your cells because the androgen receptors are being blocked by the bicalutamide.

[Tall_Allen in reply to George71]

That's kind of true, but bicalutamide is not a great androgen receptor blocker. Also, the androgen receptor easily evolves to use it as fuel. Now that we have much better antiandrogens like enzalutamide and apalutamide it isn't much used anymore except to prevent the effects of the testosterone surge at the start of GnRH agonist therapy (e.g., Lupron). Gynecomastia is mostly a problem when an antiandrogen is used in the absense of a GnRH agonist or antagonist. The excess testosterone then gets metabolized into estrogen, which stimulates breast tissue.

[GP24 in reply to Tall_Allen]

When you stop taking Bicalutamide it will be cleared from the body in a few days. Does that mean that all androgen receptors are unblocked at the same time or does the Bicalutamide already attached to the receptors remain longer? I have observed that the PSA value takes longer than a few days to increase to its initial value when you started with Bicalutamide.

[Tall_Allen in reply to GP24]

It might. But they were never completely blocked to begin with.

[kaptank in reply to GP24]

Bical has a half life of 7-8 days, which means it is a month or so before it is washed out.

[MateoBeach in reply to Tall_Allen]

Bicalutamide combined with dutasteride or finasteride or both has been advocated as a reasonable alternative to LHTHa ADT drugs for those who cannot tolerate them. I was on this for over 4 years with good disease control until bicalutamide became stimulatory to PC.

I have been wondering if perhaps enzalutamide could likewise be combined with dutasteride in this setting without ADT for longer efficacy? (Note I am not thinking of doing this myself at this juncture.)

And thank you for the info about tamoxifen vs AIs as I am starting on T replacement this week for hypogomadism SEs while I am still HSPC. Trying to decide if I should go for Supra-physiologic T or just upper range normal or cycling it. Not much in trial results out yet for the HS.

[George71 in reply to MateoBeach]

In my opinion, and just an opinion -- continuous SUPER testosterone -- if you have not yet watched the videos I have posted on this in the last few days -- you should.

Tell me if you haven't and I will post them again. low t promotes PCa cell mutation and growth of testosterone independent cells -- normal t slows that process -- super high T actually causes PCa cell death and regression due to double strand breaks in DNA -- have little to no adverse effects on healthy cells.... high t restores bone muscle wasting lessens danger of dementia etc.

[MateoBeach in reply to George71]

I did watch two of the videos you most recently posted. If you have others I will be most interested to see them. Thanks!

[Tall_Allen in reply to MateoBeach]

There is no use in thinking that men who cannot tolerate a GnRH agonist do just as well with bicalutamide. It has been proved that they don't. But if they have to they have to.

Enzalutamide's side effect profile is much worse than a GnRH agonist's.

[golfbiker in reply to Tall_Allen]

My medical oncologist is reluctant to prescribe tamoxifen because he says blood clots can occur as side effect. I am on Lupron alone, for 6 months only, so chance of gynecomastia is less than with bicalutamide (15 % vs 75% ?). Is the tamoxifen clotting risk significant, and is it worth it if one is on Lupron alone?

[Tall_Allen in reply to golfbiker]

In men treated for breast cancer, 11.9% had some thromoembolic event (vs 2.5% in placebo). The dose used for male breast cancer is 2-4 X (20-40 mg/day) the dose used for gynecomastia prevention (10 mg/day).

nature.com/articles/s41416-...

None of the reports of the tamoxifen dose for gynecomastia included thromboembolisms as a side effect.

onlinelibrary.wiley.com/doi...

But I don't think most men will suffer from gynecmastia on Lupron alone. Gynecomastia in men on antiandrogen monotherapy is a result of testosterone accumulation. The excess testosterone, unable to enter cells, is metabolized into estrogen and DHT, It is the extra estrogen that causes gynecomastia. This doesn't typically occur with Lupron because there is no testosterone.

[Bethpage]

My husband started bicalutamide in Feb. of 2019. The "man boobs" effect didn't start until May. At an appt. with an MO in May of 2019, I asked about tamoxifen. 10 mg was prescribed. I was told it wouldn't, but it reversed the gynecomastia and has worked ever since. No man boobs. Since starting the med, husband has noticed some vision changes, that he bruises more easily and perhaps that he has some extra swelling in his legs, but those symptoms could be attributed elsewhere as he has CLL.

[George71 in reply to Bethpage]

Bethpage,

thank you -- thats consistent with T/As assessment -- and encouraging that it can even reverse the boobs if they occur. I will have to switch. Are the leg swelling listed as a possible side effect?

[Bethpage in reply to George71]

George71, yes leg and foot swelling are listed as a SE, but I did not know that until recently. Honestly, my very skinny husband's legs, midway down from knee to ankle, swelled after one dose of finasteride about 8 year or 9 years ago. He developed some neuropathy in his feet as a result. That kind of subsided but reared its ugly head after one dose of sulfa in March. This time it has not subsided. There's a slight chance that tamoxifen could be playing a role, but he's also had 2 cycles of chemo for CLL, so who knows. In his particular circumstances, ,my husband would not abandon the tamoxifen on the off-chance that it could help the swelling. He's dealing. We were told my several uros and MOs who didn't particularly believe in tamoxifen that it would not reverse gynecomastia. It darn sure did.

[George71 in reply to Bethpage]

Bethpage,

how often does your husband take it please? Thanks

[George71]

Well I guess that answers that question: Tamoxifen

This is likely important to most all of us in here -- we are all likely on some type of ADT or high dose testosterone ( it can cause boobs too)

[Hidden]

Arimidex gave me bad ankle swelling. So did anastrazole. So I use letrozole. No bloating. (I went each AI and then going off, then on, then off to verify that it did appear to be the AI that was causing the bloating).

I used Tam for a few weeks. When my SOC oncologist found out she begged me to stop because she feared cardiac issues for me.

Letrozole 1.25-2.5 mg/wk has worked for my moobs. I no longer have to use my wife's sports bras!

[George71 in reply to Hidden]

Did you have mild boobs and Letrozole 1.25-2.5 mg/wk cleared them up? or no boobs and it keeps you from getting them?

[Hidden in reply to George71]

I had moobs that were big enough that I had to use my wife's sports bras. I can't be 100% certain that letrozole cleared them up. I changed from estrogen to bic to t. They were definitely growing during the estrogen and didn't seem to get any smaller on my month of bicalutamide. When I started T I started the AI. They went away.

[George71]

Thanks, good news ! I will ask to switch to Letrozole 1.25-2.5 mg/wk on next appt.

[j-o-h-n]

What? Get rid of them? Why I love my boobies...... I named one TIT and the other one TAT.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 10/02/2020 6:59 PM DST

[SPEEDYX in reply to j-o-h-n]

You always one for tit for tat!!

[j-o-h-n in reply to SPEEDYX]

actually I was thinking of naming them TAT and TIT.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 10/02/2020 7:29 PM DST

[StayPositive1]

I’m in my 3rd week of 20mg Tamoxifen. I think I’m down 1/2 a cup size, maybe more. I thank Tall Allen for his advice on this subject.

[billyboy3]

You have far more problems than large breasts pal!!!! Mine are bigger than my wife's, she says I embarrass her when I go outside the house-soon to be ex-wife but WHO cares how you look at this stage,

lord get your priorities straight, big tits is far far down the list!!!!!