Many of you have been asking if the tE2 gel that I've been using for four and a half years now will help eliminate hot flashes/flushes and the all too common side effects of Lupon injections? I thought that I answered those questions in my many trimonthly blood test results. When everything else failed and I became a candidate for ADT I refused to subject myself to the exorbitantly priced injections and the nasty side effects of Lupron. When my recently retired urologist at Loyola in Chicago suggested that I try to find DES, I began studying estrogens and happened to become acquainted with Richard Wassersug who has been using the tE2 gel as his ONLY form of ADT for over 20 years with fantastic results. Many of us are using only the gel as ADT. I can supply you with the gel if you are interested in trying it. Please read some of my updates for more information on how I am using it and my results.
Transdermal E2 Gel (tE2) As An Altern... - Advanced Prostate...
Transdermal E2 Gel (tE2) As An Alternative To Lupron
I have read your comments on E2. E2 also reduces the side effects of ADT when used in combination.
Hi Ron,
Glad you’re doing well. It will be interesting to watch the replies to this latest inquiry and see who responds with what recommendations. I’m about halfway through getting PB radiation treatments for BCR. Some form of HT will probably be on my next treatment regimen, but I’ll wait and see for now what it’ll be. Take care of yourself and keep smiling.
Jeff
Thank you Ronnie, I just ordered the book and read your bio twice, I am following you Mio
1. Estrogen lowers testosterone?
2. "I refused to subject myself to the exorbitantly priced injections "
For people on medicare isnt the cost pretty much covered?
Medicare pays for nothing abroad. Besides, I don't want to deal with the nasty side effects of Lupron when the gel is doing just fine.
Re: Q #1...
"Diethylstilbestrol (DES), a synthetic oral estrogen, was the first pharmacological agent used as ADT for PC. The primary mechanism of action of DES involves a negative feedback loop affecting the hypothalamic–pituitary–testicular axis. DES remained an effective and low-cost option for ADT from the 1950s up to the 1980s,"
ncbi.nlm.nih.gov/pmc/articl...
Oral estrogens cause problems (including early death), hence the current switch to transdermal.
Oral estrogens such as DES 'may' cause CV events and lead to early deaths; however, every prostate patient that died while using DES was 'reported' as dying from the DES whether or not they had preexisting CV issues. It was just another way for the pharmaceutical companies to justify replacing the cheap synthetic estrogen tablets with exorbitantly priced injections that make men feel like sh*t!
First of all, I live in Thailand and Medicare covers nothing abroad. Even if the injections were covered, I would never subject myself to the horrible hot flashes/flushes, bone density loss, mood swings, fatigue, pain, etc, etc, that the jabs frequently cause. I have been using the Oestrogel (tE2) for 55 months and have experienced very little muscle loss, and the only side effect is a minor degree of gynecomastia. I am 79 and still workout every day in the gym and do 4 sets of 18 to 20 pull-ups on my balcony.
this goes out to anyone using the gel and adt:
How long did it take before you started noticing relief from the hot flashes? I’m on day two and no change yet. Ty.
I can't imagine any hormone exhibiting results in two days? These were some of my early results:
4/1/2018 - 0.71 [started using tE2 4/15]
6/19/2018 - 0.49
8/3/2018 - 0.19
10/30/2018 - 0.046
1/22/2019 - 0.076
4/23/2019 - 0.014
8/10/2019 - 0.004
What gel are you using and where did you find it?
Hi there Ron Ron, I agree with you the gel must work but is impossible to have here & I have contacted Wassersug to no avail, so must wait until the cancer industry here wakes up, or maybe they do not want us to have it,? Why???
I will try to send some more to my daughter ASAP. No pharmaceutical company or doctor wants to allow an inexpensive, self-administered gel to replace $6,000 trimonthly injections. I don't think it will ever happen? BTW, I supply R.W. since the cost in Canada has gone up to about $100/tube...it had doubled in the last year.
Because oral estrogens were found to be not completely safe, estrogens as a whole were no longer included in "standards of care." There is no incentive for profit-based medicine to pursue studies of a generic med, BUT... there is an incentive for a socialized system like the one in the UK to study ways that have potential to cut costs (and thereby REDUCE the profits available to Pharma).
So the only really good study on tE2 for PC is the PATCH trial. Because of the recently reported results, docs in Australia (as in the US and elsewhere) now have "permission" to use this method by virtue of the trial results. But most docs are of course still reluctant.
physiciansweekly.com/patch-...
"The PATCH trial suggests that tE2 is an appropriate treatment strategy in men with prostate cancer, with a decreased risk of several androgen-deprivation therapy-related side-effects and similar cardiovascular risk as LHRHa. At present, no differences in efficacy have been shown between androgen-deprivation treatments; therefore, therapeutic decisions are based on availability, costs, side-effect profiles, pharmacodynamics of testosterone suppression and recovery, convenience, and likelihood of adherence. The choice of agent should be individualized based on the patient’s disease state, comorbidities, and preferences."
Does anyone know if this gel is available in Australia and what is it called.
I don't know if it's available in AU, but it's called Oestrogel.
Thanks for getting back to me. I will check it out. I’m on ADT for past 6 months and just about had enough. So this could be something that may help. Thank again
can you confirm that they are patches you apply to your skin and what dose patch is used. Thank you in advance.
Please check out my many trimonthly posts which should answer all of your questions.
Ron
Thank you Ron. I will check out your posts.
you may be able to get a similar product at inhousepharmacy.vu inhousepharmacy.vu/p-999010...
I work with two Oncologists, one here in Hartford, CT and one at Dana Farber. My local Oncologist said he would work with me regarding topical E2. Probably in November. I'll make sure to get back to you.
has anyone purchased OTC in the USA?
And has anyone used it along with Lupron?
And has anyone successfully switched from Lupron to this?
good question, I am going to search here in US.
looks like gel is available in some form. Not sure about patches.
I think patches are more readily available in America than the gel. The only gel that I use is 'Oestrogel' from France.
thanks. I appreciate your patience in answering questions. Hard to get answers from MO on this topic.
Do you have a source that will ship to USA?
I have in the past sent the gel via DHL to The US; however, we had to lie to them and tell them that it was a cream. The shipping on 25 tubes was about $140. I'm going to try to send more to my daughter Illinois so that she can accommodate some requests.
ok great still scratching the surface here. I'm stable after four years on Lupron, but always looking to learn something new and better (or even old and better!).
If you are doing well on Lupron, and don't have the common side effects, you might as well stay with it.
I've thought about doing low dose E2 to help with bone strength. But yes, my side effects have been relatively minimal (there's always the long term SEs to worry about), and injections are covered by Medicare. I need to read up on E2 and whether it is advantageous for castration resistance. Four years on Lupron and I hear the clock ticking.
does using this run into the problem of castrate resistance eventually, like ADT does?
hi Ron and friends. Here in France, I m using Estreva. 5 euros for Estreva Gel 0.1% 50g. Good results with two or three pumping (it’s a small pump) per day. Of course I use also Décapeptyl for castration.
what does your blood E2 level run on the patches?
Do you follow that?
I am interested in getting some gel from you. I am castration resistant and taking Zytiga/Prednisone along with E2 patches. I would love to stop the Zytiga/Prednisone and go monotherapy, but I’m not sure I can safely do so. Do you have an opinion on that? Or does anyone else?
The E2 gel is the only thing that I have ever used for my PCa. I will be sending more gel to my daughter in Illinois ASAP. I will post when she receives it.
Richard Wassersug is the authority on tE2 gel. He also has written books on the subject. TA may also be able to answer your questions.
All of my blood tests results are listed in my trimonthly posts.
Ron
The way high-dose E2 works against PC is by making you castrate. So I don't see how it would be helpful in a castrate-resistant state.
But in that state, LOW-dose E2 still helps to alleviate symptoms of ADT (whether Lupron or Zytiga).
So there is absolutely no evidence that switching from Zytiga to high-dose E2 would benefit you. Adding low-dose E2 might help bone health, etc.
I already use E2 patches to ameliorate the side effects of ADT (orchiectomy) and AAT (androgen annihilation therapy using Zytiga/Prednisone).
”Absolutely no evidence” regarding E2 for Castration Resistant Prostate Cancer (CRPC)?
Logic would dictate the truth of what you are saying, however the evidence points elsewhere. Here’s what appears to be a study indicating 1) estrogen HAS been used to treat CRPC in mammals (mice) with some success and 2) hypotheses regarding method of action:
ncbi.nlm.nih.gov/pmc/articl...
Here’s another one, but with humans:
pubmed.ncbi.nlm.nih.gov/321...
Wow, that mouse study is pretty wild. So I stand corrected on my statement that I don't see how E2 would be helpful in a castrate-resistant state. It appears that it CAN help. But is there evidence that it would be a better treatment than Zytiga, used as monotherapy, to help prolong survival? I don't see it.
Regarding study 2:
"Five (13%) of 40 patients had > 50% PSA reduction for at least 1 month at any transdermal estradiol dose."
It is not clear, but wasn't the tE2 added to the ADT rather than replacing it? What was the long term efficacy? Did any of the 35 of 40 men possible have PC progression BECAUSE of the tE2?
But I guess I should repeat and qualify my claim: " there is absolutely no evidence that switching from Zytiga to high-dose E2 would benefit you " essentially means that nobody has studied such a replacement of therapy, so far as I know. Perhaps there are mechanistic reasons to think it COULD be of benefit, and I'm not saying it couldn't. Just sayin' it would be a total crap shoot.
Richard Wassersug says in the video discussion I mentioned in another post that he thinks tE2 probably does not have a role in castrate-resistant PC, and that was after many conversations with Ruth Langley, who ran the PATCH trial. But then again PATCH was not set up to look at that, so how would she know, lol?
There certainly is evidence that DES can help, but Patrick mentioned in some of his posts that he think DES has intrinsic anti-PC properties different from tE2. So be careful if assuming a DES benefit will translate into a tE2 benefit.
Thanks for the links!
Since it appears I am Zytiga-resistant, I am forced to consider alternatives. And I saw the Wassersug video yesterday. My brother and I are doing a podcast on all this good stuff. We were both diagnosed with prostate cancer at the same time.
So sorry to hear about you and your brother having to fight this shit!
Hey RonRon. Its always great to read your posts. Very hopefull. I am currently on ADT vacatión, thinking, as I once told you, of trying oestrogel when things start getting tough again. Hang in there, amigo.
Is my understanding correct that Estrogel is not available in the US? If that is the case, how does one order it from your daughter?
Joe, I have in the past sent the gel via DHL to The US; however, we had to lie to them and tell them that it was a cream. The shipping on 25 tubes was about $140. The PO would not accept it. I'm going to try to send more to my daughter in Illinois so that she can accommodate some requests.
Thanks for getting back to me Ron. I wish you the best. Lets stay in touch from time to time.
Will do!
Hey Ron... I think it is important to add that Richard Wassersug has given a caveat about the possibility of tE2 being ill-advised for men with estrogen-sensitive PC. This could include men with a family history of breast cancer, or with BRCA (or other) mutations.
I will not provide a link here, but if one goes to 39:30 in the YT video titled "03/29/2021 - The Role of Estrogen-Based Hormone Therapy for Treating Prostate Cancer" he gives it a quick mention. (The entire tE2 discussion here is 1-1/2 hours long, but worth watching for those interested.)
Also worth noting is that not all men will become castrate in a timely fashion when pursuing tE2, even at what should be "high-enough" doses. My T took a few months just to get below 100, nowhere close to the <4 level I reached with Lupron, Firmagon or Zytiga. (Having low T but not castrate T is NOT good when treating PC!) In the meantime, possibly because I do have estrogen-sensitive PC, my own PC really took off during these non-castrate months, w/ a spike in PSA and ALP and lots of new mets. So... buyer beware.
Readers should be sure to differentiate between the mode of high-dose E2 -- actually a form of ADT, where castrate level of T are reached BECAUSE of the tE2 itself -- and the mode of low-dose E2, which is ADDED TO other forms of ADT (like Lupron, etc.) to alleviate some ADT side effects. They are two very different things, requiring very different doses.
Also, readers should note that patches and gels/creams are just different delivery modes of tE2, but when I spoke to RW he was not convinced that these modes work in the same way for all men. (He tried explaining why, but quickly went over my head!)
Best,
Noah
Thank you Noah for the important information. I think you know more about E2 than I do? I do know that it is not for everyone such as in your case where you have estrogen-sensitive PCa.
Hopefully most of our comrades will read your post. Perhaps I should include some of this info in my next tE2 blood test update which is coming up soon.
I will print some info here & show it to doctors & will gladly be their test rat.
It appears to me to be a good maintenance option when free from ADT as if one was on vacation from these debilitating drugs.
keep on keepin’ on, ronron. Thanks for reminding all of this option once again. You are the Pied Piper of tE2.
Have you done your trip back stateside for advanced treatment assessment that you were planning? Don’t recall the details. Paul
Hi Paul,
I'm planning on going to Loyola hospital in Chicago in the spring for the AUS surgery. I'm still trying to decide on which Medicare supplemental plan to buy? I've talked with the folks at United about the AARP plan; however, I need to do more research before I decide. I guess I have to wait until October to sign up and then wait until 2023 for coverage. At this point I have no idea who to go with? Thanks for your concern!
Ron
AARP Just has a marketing agreement with United. Does not imply higher quality. All of the supplemental plans have identical coverage. So only difference is cost and quality of servicing. Go for the highest tier which is now Supplemental Plan G. Thank use Alliance, has been very good. With Plan G no one will turn your business away.
Your beautiful sweetie will appreciate your continence with the AUS. Worth it!
May need to come visit you some day. It’s been too long since visiting Thailand. Paul
Thank you Paul for your reply! I would love to see you here if you if/when you come.
Ron
