E2 Patch

I've been on ADT + Zytiga + Prednisone for 46 month's. In that time I've developed osteopenia, and have suffered an "Osteoporotic" compression fracture to the t11 vertebra, even though I've been receiving XGEVA, and taking Calcium Citrate, D3, and Multi vitamins as directed. I've read studies of e2 being effective in restoring bone health, as well as maintaing "Castration Levels" of Testosterone, with fewer harmful side effects than abiraterone. My MO won't even discuss estradiol (e2 patch), as an option. My question is this, Is he taking the "Standard Of Care" a little too far by not entertaining options that may be more beneficial to my overall health and QOL? And, should I look around for a "Prostate" Cancer MO instead of general cancer MO?

Thanks in advance for any suggestions, or advice, as keeping the beast in check is great, but not great enough to live in constant fear of suffering a debilitating bone fracture. Not to mention all the other adverse effects of a steady diet of Zytiga and Prednisone.

[Hidden]

If your MO does not believe in shared decision making, then search out another.

[Hidden in reply to Hidden]

USA

[Tall_Allen]

Will he allow an E2 patch along with conventional ADT?

[Hidden in reply to Tall_Allen]

I'm going to reach out to him tomorrow and discuss. My main concern is the osteoporosis risk

[Islandboy2021 in reply to Tall_Allen]

I have my bone specialist write me a prescription for E2 gel. Where is the best place to apply it and how much.

He said that I need to be careful for blood clots while taking the E2 gel.

Thanks

[6357axbz in reply to Islandboy2021]

Are you saying he didn’t tell you where to apply and how much???? Get another doc

[meowlicious99 in reply to Islandboy2021]

> He said that I need to be careful for blood clots while taking the E2 gel.

I was under the impression that gels avoid 'first pass effect' in liver with production of prothrombotic proteins.

Also how does one about being 'careful' for blood clots. Periodic D-Dimer tests?

[Islandboy2021]

I have been asking for the E2 patch as well. I have been diagnosed with osteoporosis now after the last DEXA scan. I am still waiting for the Xgeva to be approved. It’s unbelievable that they don’t notice the benefits of this E2 patch.

[Hidden in reply to Islandboy2021]

I did XGEVA once a month for 2 years, then was tapered to once every 3 months...obviously it didn't help with the bone density, as I suffered a spine fracture within 6 months of the tapering, and my DEXA Scan was not so good (osteopenia) with -2.3 in femoral neck and -1.5 in hips and lumbar spine. With the better number in the spine, I have to wonder if the fracture was misdiagnosed as "Osteoporotic" when perhaps it was "pathologic".

Either way, I think I would benefit from the e2 patch

[MateoBeach]

Agree that adding estradiol patch would be a positive one. Consider getting a D3 product with K2 to possibly help protect arteries from the calcium. I would not stay with an MO who is not willing to look at evidence and discuss with me and consider my preferences, potential benefits vs possible risks based upon available published research.

[Hidden in reply to MateoBeach]

I will be seeing him to discuss my concerns. I contacted the office, and his directions were that I schedule a visit prior to my next scheduled injection date on June 20.

[hg115pb]

estrogen patch has multiple potential benefit including bone health and reducing hot flashes. It is not standard of care tho Sone docs are comfortable thinking outside tge lines and others not. Certainly consider a second opinion with a prostate cancer medical oncologist. Not available in many communities but if you are able it might help with the decision to try estrogen

[Islandboy2021]

Which is better the E2 gel or the patch.