Is it true that Testosterone is not the culprit causing Advance Prostate Cancer, Estragon is?

[Pcnmyy]

Hello Friends, I came across an article by Dr. Ray Schilling (askdrray.com/whats-new-abou... that claims Testosterone is not the culprit causing Advance Prostate Cancer, Estragon is. He also claims that ADT is an outdated therapy. Is Dr. Schilling right? Why other Oncologists/Urologists (including mine) keep prescribing the ADT therapy? I would very much appreciate your thoughts and clarifications.

[Tall_Allen]

So wrong! Testosterone does not cause prostate cancer - no one ever said it does. However, depriving existing prostate cancer of all testosterone will certainly slow progression. Estrogen was the first therapy used to treat prostate cancer and is getting another look. It stops men's bodies from producing testosterone.

The internet is full of quacks. Your health will improve if you ignore such quacks.

[Pcnmyy in reply to Tall_Allen]

Thank TA for your prompt and valuable insight.

[jhrocket in reply to Tall_Allen]

Estradiol turns on the cancer. There is a school of thought as the ratios of testosterone and progesterone drop, estradiol is relatively higher. There is absolutely no evidence that estradiol drives the cancer. Although testosterone doesn't cause the cancer, one prominent onco-urologist describes testosterone as water for a plant vs older analogies fuel for the fire.

[Tall_Allen in reply to jhrocket]

Estradiol is being used to treat prostate cancer:

thelancet.com/journals/lanc...

[jhrocket in reply to Tall_Allen]

My friend that is very old. They don't use that in the US any more. They may over seas.....but it irrelevant, the cancer cell is a whole different creature from a normal cell. I know from this forum they use diethylstilbestrol overseas they used to use it here before the fancy androgen blockers

[Tall_Allen in reply to jhrocket]

My friend, check the date. It is very new. They stopped using estrogen pills many years ago because of blood clots. With the advent of transdermal estrogen, that concern is now gone.

[jhrocket in reply to Tall_Allen]

its in the lancet which is English, not America......i said it is used overseas probably because of price. These men has radical prostatectomies............its probably about price....drugs like Lupron are very expensive. Once again the cancer cell is not the same as a normal cell......estradiol turns on the cancer

[Tall_Allen in reply to jhrocket]

PATCH/STAMPEDE is a large randomized clinical trial in the UK among both newly diagnosed advanced prostate cancer patients and recurrent patients. Men are randomized to either an estradiol patch or a drug like Lupron. So far, it seems to be equally effective. There are many advantages of estrogen over GnRH agonists, like hot flashes, bone density, lean muscle mass, heart blockage, and fatigue. Results are expected in a couple of months. You may want to switch when the results come in.

clinicaltrials.gov/ct2/show...

[jhrocket in reply to Tall_Allen]

Yes adding estradiol influences the hypothalamic pituitary axis, consequently it turns off testosterone production and feminizes men, like breast enhancement.There are better ways to strengthen bones. Friend if you become castrate resistant,

this could buy you more time. I disagree with your assessment of estradiol: lean muscle mass, heart health not in men! Women make 80 per cent of the androgens that men make. What man wants a set of irreversible breasts?

[noahware in reply to jhrocket]

Since it is the loss of estrogen that weakens bones in men on ADT, what would be a "better" way to strengthen them than replacing lost E2, and why would that way be better?

The breast issue can be addressed by the SERM tamoxifen.

You may disagree with the assessment of estradiol given by TA, but it is not "his" so much as that of the researchers to which he referred. Can you provide links to research that discusses how and why tE2 might be worse for men than ADT, in terms of lean muscle mass and heart health?

[jhrocket in reply to noahware]

Friend over the years i have been a student of the "bone issue" I'm happy to give you the answers....you can go fish out the papers. Potent phytoestrogens in plants like pueraria mirifica will maintain cortical bone. Estrogens do not maintain trabecular bone which is hip. There is vitamin used in Japan that they use for osteoporosis. It isone of two versions: Vitamin K2 the MK4 Version builds bone even trabecular bone (short half life). Dosage 15mg 3 times/day. It is the synthetic version. You can not get it in your diet. The other version is mk-7 it comes from fermented soy called natto. It helps to maintain bone but it does not build bone. It has a long half life....it is sold in micrograms. The MK-4 version costs about $40 to $50/month.

Friend my dad had a radical prostatectomy at 75. At 85 he walked into his doctors office, the guy ran a PSA and it came back a 20! My Dad started Lupron made him feel crummy must have been real crummy because it was the only time he listened to me. The Lupron pushed him under a 1. We had a talk with his doctor.....told him we

wanted to use Lupron intermittently......and use 8 TO 10 MG OF PROGESTERONE.

This put him in remission for 7 years. No side effects no more Lupron. My Dad made one mistake about 3 years in....he stopped following directions, meaning he was supposed to changed location each time he put the cream on.....he thought he was out of the woods and it cost him a round of Lupron. Why does progesterone work? It down regulates estradiol, it up regulates a gene p53 (apoptosis) it down regulates p13 (turns on the cancer) I have the citation is buried in a old computer in JAMA!

The pharmaceutical companies can not make any money with progesterone consequently no one is pushing it. Going about a 8-12 mg range makes the cancer grow as does too much estradiol.

[noahware in reply to jhrocket]

"I'm happy to give you the answers....you can go fish out the papers"

So you have no citations or references, only "answers" (via anecdote and assertion) for me? If you are actually a student of bone health, then you have actual sources for your information. No interest in being a teacher, and sharing the sources?

I have no doubt there are many ways to treat PC, and many ways to treat bone issues. That some can succeed (or possibly fail) does not make them definitively "better" than others that can succeed (or possibly fail), in any objective sense, without objective comparative studies and mechanistic analysis/explanation.

"The pharmaceutical companies can not make any money with progesterone consequently no one is pushing it."

Yes, and the pharmaceutical companies can not make any money with estrogen, either, and so consequently no one is pushing it. That is the reason you observe it is not widely used anymore.

[jhrocket in reply to noahware]

Friend I have nothing to prove......i have tons of papers buried in my computer disks....i'm not looking for them......you want to use estrogen your loco!....I gave you some simple solutions......I'm not going to argue with you......Your oncologist / Urologist is going to think your loco also. Your too lazy to look for the science?Possibly the potent phytoestrogens in pueraria mirifica will help you with your hot flashes. Lifting weights help many men on ADT..........like I said my dad went into remission until he passed away at 93..........stopped Lupron completely . The password is progesterone not estradiol!

[FRTHBST in reply to jhrocket]

One confusing point in your discussion of progesterone use- you say that your father used 8 to 10mg of progesterone and later that the "8 to 12 mg range makes the cancer grow." Can you elaborate?

[jhrocket in reply to FRTHBST]

The typical range is 8 to 10 mg................Some men are very ,very large in that event the range would be 10 to 12 mg

[Tall_Allen in reply to jhrocket]

Friend, some take tamoxifen to prevent gynecomastia.

"If estrogen can help androgen-deprived men (as well as postmenopausal women) to be more alert during the day, it may potentially alleviate the fatigue associated with androgen deprivation therapy. Furthermore, supplemental estradiol may reduce cognitive impairment in these androgen-deprived patients by improving their sleep."

"Many of these side effects, such as hot flashes and an increased risk of osteoporosis, are identical to what women experience at menopause, and they arise for the same reason. The cause is a large decline in levels of estradiol, and in both sexes those side effects are diminished when the individuals are given some supplementary estradiol."

go.gale.com/ps/anonymous?id...

"Transdermal oestradiol as a single agent produces castration levels of testosterone while mitigating BMD loss. "

sciencedirect.com/science/a...

"Beneficial arterial effects of estrogen may be mediated through an improved lipid profile as there is evidence that estrogen reduces low-density lipoprotein (LDL) and increases high-density lipoprotein (HDL).65 Similar favorable lipid changes have been observed with the use of parenteral estrogen as ADT for PC (see Table 1).21 Results from the PATCH trial showed that at 6 and 12 months, mean fasting cholesterol increased in the LHRHa arm but decreased in the estrogen arm, whereas HDL increased in both. Mean fasting glucose increased in the LHRHa group at 6 months and again further at 12 months but showed a decrease in the estrogen group at 6 months, which was maintained unchanged at 12 months. "

touchoncology.com/genitouri...

[Joeym1040 in reply to jhrocket]

i am not as well versed as yourself and Tall Allen, but i did spend a year in a clinical trial using estrodoil get as the only treatment. I had radiation to my breast area prior to starting the trial. Turned out to be the best year of my life. All my cliniclal numbers (measured every 2 weeks for 6 months and then every month for the following 6), Hot flashes disappeared, no breast enlargement, didn't need to shave as often, etc.My practical experience was very positive for a year.

[TheTopBanana in reply to Tall_Allen]

is there any difference in regards to becoming castrate?

[Tall_Allen in reply to TheTopBanana]

The GnRH antagonists are quicker.

[noahware in reply to jhrocket]

It is used in the US, by myself and others on this forum. It is not WIDELY used, because of the prior issues with oral forms (which WERE successful for PC treatment but helped men to die earlier of other causes).

[Farmhand in reply to Tall_Allen]

Careful using estradiol which is a steroid hormone with advanced aggressive prostate cancer! It can repress the cancer temporary and then fuel it! One year ago I had PSA 200 large tumor left iliac node no other metastasis. Used estradiol transdermally for one month which lowered PSA 100 points . Was very excited about the success and continued another month with the estradiol gel two weeks into second month of use PSA jumped to 650 with bone Mets too numerous to count ! Immediately stopped estradiol and started Eligard. Here is part of an article which describes how aggressive advanced cancers can switch over to using estrogen!:"underestimated aspect of prostate cancer progression regards the cross-talk between androgen and estrogen signaling pathways. It has been demonstrated that ESR2 is down-regulated in epithelial cells during development of prostate cancer [9]. ESR1 is up-regulated in tumor cells as well in the tumor microenvironment. Its expression increases during prostate cancer progression [9]. Moreover, there is evidence that ESR1 antagonists can repress prostate cancer tumorigenicity [10,11] and that abiraterone can activate estrogen receptor [12]. Data were also produced demonstrating that prostate cancer cells can use alternative nuclear receptors signaling pathway, such as ESR1 instead of AR signaling, to propagate "[13].

[Tall_Allen in reply to Farmhand]

The only thing that counts is what occurs clinically. We will have the full results of PATCH/STAMPEDE very soon.

[TheTopBanana in reply to Tall_Allen]

How soon?

[Rickmartin1948 in reply to Tall_Allen]

Thank you for the info TA, I am using very low dose patches , one 25mg patch every three days and it stopped my hot flashes a little bit but no big change. Obviously the prescription came form my oncologist urologist who is cool but is too busy to dive into sideroads, that is here in Prague, social medicine, high quality but very depersonalized, you have to fill in the gaps between spcecialists, I am liason between my cardiologist and the oncologist.

Anyway TA what you bring to the table is very exciting and I think it implies much heavy dosing od Estradiol

[noahware]

Dr Ray writes, "Some physicians still practice the old method of hormone depletion therapy in advanced prostate cancer cases. But Dr. Morgentaler and other researchers have shown that it is wrong to do hormone depletion therapy or orchiectomies."

I think Dr. Morgentaler might be surprised to learn that he has shown that it is wrong to do hormone depletion therapy or orchiectomies.

He recently wrote that he sees "a potential role for TTh in selected men with advanced or metastatic PCa. Further investigation is warranted to identify treatment strategies that provide adequate cancer control without the full negative impact of ADT."

In other words, he clearly thinks it is not "wrong" to do ADT but also happens to think it is not always wrong to incorporate high-T into hormonal therapy for all men, supposing SOME men may get QoL benefits by doing so, without severe negative impact on PC progression.

By definition, a proponent of something like a modified BAT protocol cannot believe ADT is "wrong" because ADT is an integral component of BAT... it is the half of the therapy that makes it "bipolar," after all!

So the quoted passage is a misrepresentation of Dr. M. and his work. I won't bother to note the other errors made by Dr. Ray, but there are more than one.

[HopingForTheBest1]

As my testosterone level continues to be in the single digits, with ongoing ADT, my disease continues to progress with growing lesion size and PSA. Maybe the focus should now be on controlling Estrogen, and moving on to BAT? My routine ongoing blood work doesn't even test for Estrogen levels, as far as I know.

I was able to find Dr. Morgentaler's office in order to get an appointment, but he is now retired. It also appears that his methodology is not commonly accepted nor practiced?

[VHRguy]

Dr. Charles "Snuffy" Myers used estradiol transdermal patches at low doses, 0.025 to 0.05 mg/day, to offset side effects for his patients on long term hormone therapy. He clearly was not concerned about estradiol "causing" prostate cancer, or he wouldn't have prescribed it for his patients with advanced cases.

For reference estradiol (E2) is the "active" part of estrogen which includes estrone (E1) and estradiol (E2). If you get your blood checked, be sure to ask for the E2 number specifically.

[EdBar in reply to VHRguy]

I’m still using estradiol patches prescribed by Snuffy from when I was a patient of his for ADT SE’s, my current PCa MO - Oliver Sartor has no issue with the patches and feels they’re good for bone health as well.

Ed

[VHRguy in reply to EdBar]

Cool! Glad to hear from one of his patients. I watched so many of his video blogs about prostate cancer. His approach was refreshing, in that he was so very patient-centric in his treatment concepts. Definitely willing to be on the cutting edge.

I use estradiol patches too, and feel absolutely great.

[pjoshea13 in reply to EdBar]

Low-dose E2 patches are intended to replace the minimal amount of E2 essential for bone health. Men produce E2 by aromatization of T. ADT can therefore result in E2 defficiency. IMO, the target level for E2 should be 12-20 pg/mL.

E2 is only a threat to male health when >30 pg/mL. Some studies (e.g. cardio) equate the E2:T ratio with risk.

{When massive levels of E2 are used to suppress T, the ratio becomes meaningless.}

[sm60]

A feminized and essentially castrated older adult male population (that is still somewhat educated in Americanism-- by comparison to current generations) suits the NWO very well.

[Hidden in reply to sm60]

What does the WWF have to do with this? The NWO was a great group of wrestlers that epitomized masculine qualities....great era of wrestling

[CAMPSOUPS in reply to Hidden]

I think your reply to sm60 should have been WTF. He referred to New World Order when he used NWO.

He also disparaged 95% or so of us here who are under treatment with his comment.

I think he got bored with whatever social media site he posts his hate and anger to the world at and came here to do so. A shame because this thread has a lot of good discussion.

[Hidden in reply to CAMPSOUPS]

No need to go low..satire is still the best reply IMO

He didn't reply so he 1. Didn't get the satire or 2. Is exactly as you claim. Either way, conspiracy thinking is lazy thinking.

[CAMPSOUPS in reply to Hidden]

Thanks. Your absolutely right on all counts. Need to get my head screwed on straight and not get bothered. Normally do so. I got out of line this time.

[Hidden in reply to CAMPSOUPS]

Not sure if you got my humor but back in the late 90s there were a group of wrestlers in the WWF called NWO or New World Order..hulk hogan, randy savage were members.

[CAMPSOUPS in reply to Hidden]

I did actually but went with the 1% just in case and opportunity to do my own venting. I knew pretty much it was satirical and appreciated it. For some reason I let his comments get under my skin. Not good. I'm not that way. I'm all for enjoying these remaining years and satire/humor like yours is the way to go.

[podsart]

I was surprised when I mentioned dr Liebowitz toDr Myers, Dr Myers said Dr Liebowitz wasn’t any better than a used car salesman

[pjoshea13 in reply to podsart]

In "Beating Prostate Cancer: Hormonal Therapy & Diet" by Dr. Myers (which I do not pwn), Myers mentions Dr. Robert Leibowitz's success with the triple hormonal blockade therapy in inducing durable remissions.

Elsewhere, Myers mentios that Leibowitz was an early mentor. However, Myers backed away from T restoration when he had one patient whose disease really took off & couldn't be controled.

I do think that "Dr. Bob" was somewhat into self-promotion, but I could name a few others in the field.

-Patrick

[podsart in reply to pjoshea13]

Thanks

[Seebs9 in reply to podsart]

I'm looking for a used car...

[sm60]

Some people take the Malthusians at the WHO/CDC (and their twisted billionaire associates/allies at the U.N., and most major national governments,) etc., at their word, and seriously. You are free not to at your own risk.

[noahware]

Another point to add: what actually CAUSES a cancer may or may not have any bearing at all on what might best be used to TREAT a cancer, once it has progressed to clinical significance (which for PC takes years, if not decades).

Whatever might have been the root "cause" of my PC may be of academic interest, but as a practical matter I am far more interested in different ways to slow it down, to delay symptoms (and death), now that it has metastasized.

Should I suddenly find "proof" that estrogen caused my PC (way back when), that in no way changes the clinically established fact that estrogen therapy (right now) can also delay its progression.

If you are guilty, dear estrogen, I forgive you... now get to work and give me remission!

[podsart]

Ok