Leg Pain

I was diagnosed with Stage 4 Prostate Cancer in May 2019 and immediately started on ADT. The treatment seems to be working pretty well, as PSA and Testosterone have plummeted , 620 to 0.5 PSA and Below 3 Testosterone. My only noticeable bothersome side effect was Hot Flashes, but they subsided after about 8 months of treatment. Aside from the bone pain from the mets, I also had serious Neuropathy issues with much pain, sciatica, and numbness. Doctor started me on Cymbalta in Dec 2020 to help with the Neuropathy, and it seems to be helping somewhat. However, the Hot Flashes have returned with a Vengeance, and now I experience debilitating Leg Pain /Sensations preceding the hot flashes AND while sleeping. Also Night Sweats, I've never night sweats had before. I tend to think the pain and strange leg sensations are more related to the cancers bone marrow infiltration, and less a byproduct of the Cymbalta, as I had experienced similar sensations well before the Cymbalta. Is there anyone here that has experienced anything similar? My left foot and leg are constantly tingling / numb with intermittent pain. I have a great deal of pain in my sternum as well as in my Spine directly behind the sternum. Occasional Left Hip pain and lower spine pain near tailbone. My other concern is a serious shortness of breath, sometimes I'm winded simply from having a conversation, then I'm raspy, hoarse, and begin to cough. There was Pulmonary metastasis visible on original scan, that has since subsided as a result of the hormone therapy, but apparently, though the masses have subsided, the effects of Pulmonary mets hasn't. I'd appreciate any comments or similar experiences.

[pjoshea13]

Hear what Dr. Myers has to say about estradiol for Hot Flashes, bone loss, etc:

askdrmyers.wordpress.com

"Transdermal Estrogen + ADT"

"Posted May 27, 2016"

skip to 4 mins

rxlist.com/vivelle-dot-drug... ... use lowest dose

test estradiol [E2] - it should be 12-20 pg/mL

-Patrick

[Lika-g in reply to pjoshea13]

Is it bad if the estradiol level is higher than 20? My father is between 28 and 38 pg/ml....

[Break60 in reply to Lika-g]

Mine is over 100! But I use 3 patches weekly. No problem.

[pjoshea13 in reply to Lika-g]

20-30 pg/mL is considered to be the optimal estradiol [E2] range for healthy men. >30 is associated with cardio issues; <12 with bone issues.

***

Classic ADT can easily put E2 below 8 pg/mL, & bone loss will be fairly rapid.

Men who use E2 for ADT might get above 500 pg/mL:

"The mean ... serum estradiol level increased from 17.2 pg.mL (range, 14.8-19.6 pg/mL) to 460.7 pg/mL (range, 334.6-586.7 pg/mL)." [1]

The UK PATCH trial continues, so any morbidity associated with super-high E2 is presumably no worse that that due to Lupron, say.

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/156...

[Lika-g in reply to pjoshea13]

Thank you for your detailed answer.🍀

[Break60]

One .1 mg estradiol patch weekly stops hot flashes; use 3 and you can toss the ADT treatment!

[j-o-h-n]

I take1 Duloxetine (Cymbalta) Hcl Dr Caps 30mg once a day (for leg/nerve pain) - It's a summertime med, summertime it works, summertime it doesn't.

1 Neurontin/Gabapentin 600mg twice a day (for peripheral neuropathy).

No hot flashes.

Balance Kaput.

Memory Kaput, Kaput.

Looks like we're in the same boat without paddles....

Pca sucks..........

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 03/01/2021 7:39 PM EST

[j-o-h-n]

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j-o-h-n Monday 03/01/2021 7:43 PM EST

[Psychmed]

Kaput. Ya. Cymbalta can be dosed up to 120 mg so increasing dose might help. Second gabapentin as well. Max dose about 3200 mg a day.