The estradiol patch test in the U.K. appears on hold. Does anyone in the community know why?

[kreg001]

cancerresearchuk.org/about-...

[GP24]

On this page they write: " ... and recruitment to (viii) Transdermal Oestradiol (Arm L) will now be evaluated."

stampedetrial.org/centres/i...

Maybe they stopped it due to low recruitment.

[noahware]

Perhaps as a COVID precaution? [I wonder what "on hold" actually means. Is it on hold because it is fifteen years in and scheduled to end in several months? The NIH site still says "recruiting."]

A search (PATCH homepage?) finds this, but it's unclear as to the date written:

"The PATCH trial has already shown transdermal oestradiol can suppress testosterone as effectively as standard hormone therapy, while having a number of other potential benefits:

• It does not cause the bone to thin.

• Men treated with transdermal oestradiol generally reported better quality-of-life than those on hormone injections.

• Cholesterol and glucose levels increased in men on hormone injections but decreased in those on transdermal oestradiol.

The PATCH trial has been extended in order to look at whether transdermal oestradiol patches can control prostate cancer as well as standard hormone injections."

I assume that extension refers to the current posted end date of Aug. 2021.

[GP24 in reply to noahware]

No, the PATCH trial was continued as arm L in the STAMPEDE trial.

However, this page indicates that recruitment has been suspended due to the COVID situation:

patch.mrcctu.ucl.ac.uk/

[kreg001 in reply to GP24]

Thanks. I see.

[LearnAll in reply to noahware]

Estrogen therapy can work well for men with less aggressive Advanced PCa. Estrogen, being female sex hormone also protects against heart attacks and causes less bone damage. Women have low rates of heart attacks before menopause because they have plentiful of estrogens. The icing on the cake is that Estrogen is an anti depressant. Have you noticed pregnant women in their 2nd and 3rd trimester are :happy ..jolly" but after delivery, when their estrogen levels plunges...they develop "baby blues" or even Post Partum Depression.

The main criticism about Estrogens is that it can cause clotting issues...BUT...PCa itself is a hypercoagulable state...Nothing new here. Now, Clotting tendencies can be controlled by use of blood thinning spices such as Turmeric, Garlic, Ginger etc. If still not controlled, Low dose aspirin or Nattokinase can do it,

[kreg001 in reply to LearnAll]

I’m post a 2nd biochemical recurrence, Doing Lupron and PSA climbs 0.3 or 0.4 every four months. Slow, I’m told. Currently at 3.7. Prescribed Casodex to add to the Lupron after Auxumin scan next week. But, I think estrogen patches are worth a go. Hard to find a physician willing to write a script here in Cleveland. Hoping the UK PATCH test was near completion. Help persuade my ‘team’.

[LearnAll in reply to kreg001]

Until Estrogen patches are declared part of SOC, An American Doctor will not write prescription due to extra legal risk of using an off label medication.

[kreg001 in reply to LearnAll]

Right. Learning this the hard way. Thanks.

[Tall_Allen in reply to LearnAll]

Not true. I've seen MOs write scrips for it.

[kreg001 in reply to Tall_Allen]

Good to know.

I’m striking out in NE Ohio. Interviewing another in a few weeks.

[Tall_Allen in reply to kreg001]

Did you try the Cleveland Clinic?

[kreg001 in reply to Tall_Allen]

Lot of folks, but I did meet with the head of urology before he left. Trying another hematologist MO in two weeks after auxumin scan.

[EdBar in reply to LearnAll]

I’ve been able to get estradiol script for years, no problem. Originally from Snuffy Myers, now my local MO writes them and my PCa specialist, dr Sartor thinks they’re a good idea. Helps greatly with hot flashes, etc.

Ed

[kreg001 in reply to EdBar]

Dr. Smith is no longer practicing I read.

[EdBar in reply to kreg001]

Dr. Smith?

[noahware in reply to EdBar]

I think you are talking about getting low-dose patches as an add-on to standard ADT, rather than the use of high-dose patches as a non-standard form of ADT itself (with no Lupron, etc.). The latter is what the PATCH trial is all about. I suspect getting docs to consider the former is much easier than the latter!

[Mascouche in reply to LearnAll]

Hi LearnAll,

According to the doctor in this video, the blood clotting dangers from the Estrogen path is only for women and in the case of men, it actually lowers the risk of blood clotting.

Transdermal Estrogen + ADT For ProstateCancer

youtube.com/watch?v=KBpg_SE...(Not working as expected?)

[LearnAll in reply to Mascouche]

Mascouche, Thanks for posting this video in which Top Guru Dr. Charles Myers clarifies that if estrogen is taken by a skin patch, it bypasses the liver and thus, avoids many side effects including clotting problems. It reminded me of some papers which stated exactly the same idea.

[Guber]

kreg

my oncologist prescribes the patch for me, so some do.

ask yours again, if he wont, ask him for the name of someone who will

by the way it works and i have no side effects, although i never took lupron so maybe i would have had the same results with it

[noahware in reply to Guber]

I assume this is a high enough dose to act as ADT? I am curious whether you had to work hard to convince your oncologist. (Also curious where this oncologist is located!) My MO seems not to even know that tE2 is a form of ADT.

[kreg001 in reply to Guber]

Thanks.

[noahware]

[EDIT: reposted as reply to Guber]

[MateoBeach]

You have to be willing to educate your MO when necessary. Estradiol either as an alternative form of ADT or as an adjunct to it to prevent adverse SEs is worth pursuing. Print out the studies that show it is safe and effective and present them. My MO just wanted me to declare for the record that I understood the treatment and it’s potential risks and accepted them. Standard informed consent. Then he wrote the script.

[kreg001 in reply to MateoBeach]

Right. Thanks. That’s why I was checking on the progress of the patch test. I’ll organize a binder with what I have.

[Tnjw]

After making my urologist aware of the trans dermal estridol patch benefits as an adjunct to adt , he prescribed for me. .05mg changed twice weekly and they are for me a game changer ... side effects of firmagon have been mitigated.

[kreg001 in reply to Tnjw]

Thanks.

[Hidden]

👏👏👏👍

[Guber]

noah

as others have answered, ask, and if he says no ask for a referral or go somewhere else.

09/14/2020 PSA 23, T 559

10/21/2020 PSA 5.9, T 18

[janebob99]

I was told by the lead researcher, Ruth Langley, that the results will be published this Fall.

[kreg001 in reply to janebob99]

Thank you.