Fosfestrol ( oral Estrogen )/ Honvan for mCRPC progression ?

[meowlicious99]

Complete case history in profile.

Current therapy: ADT + Abiraterone + Pred

PSA has gradually increase from a nadir of .7 in july 2022 to 4.5 in april -2023

Latest PSMA

- Sclerotic lesions in left iliac bone and sacrum , showing increase tracer uptake

- Low grade PSMA avid aortocaval lymph node - ? metastatic

Comparison to previous:

- prostate lesion remains unchanged

- mild increase in avidity and extent of skeletal lesion with new focus of sclerosis in left illiac bone

- interval appearance of in aortocaval lymph node

Our oncologist recommended Fosfestrol ( en.wikipedia.org/wiki/Fosfe... ) once daily oral medication ( we are in india) for 1.5 months.

recommendation: ADT + Fosfestrol 120 mg.

I see terrible CV side effects from Fosfestrol . Is this worth the risk

[GP24]

If you take it for 1.5 months there will be no terrible side effects. In the long run (2-3 years), it increases the cardiovascular risks. What you will experience is that your hot flushes from ADT start to disappear.

[Tall_Allen]

Estrogen patches don't have the bad CV effects that pills do.

[meowlicious99 in reply to Tall_Allen]

Thank you TA!

I've been searching and calling pharmacies but patches don't seem to be available here in india for some reason. I will keep looking.

Would you know what the equivalent dose via patches would be.

[Tall_Allen in reply to meowlicious99]

Sorry, IDK.

[E2-Guy in reply to meowlicious99]

Can you buy estradiol gel in India? The gel that I buy here in Thailand is made in France by Besins.

A tube of E2 gel

[tango65]

Request estrogen patches which could reduce the incidence of cardiovascular risks.

The cancer has become metastatic castration resistant PC with bone and lymph nodes metastases. Consider to request chemotherapy plus ADT instead of doing Fosfestrol.

[binati]

They are available in India. Look for Estraderm MX 50 Transdermal Patch for example. There will definitely be others.

[dhccpa in reply to binati]

Can it be shipped from India to the USA?

[binati in reply to dhccpa]

You can also try Thailand. Yes they can probably be shipped from India to any country. I will try and get some details.

[dhccpa in reply to binati]

Thanks. Please do, as the dilemma of finding it in USA comes up regularly.

[Bluebird11]

Our doc recommended Honvan but not a pill a day. He had a unique way of us taking it in liquid to titrate into drops. It worked for him- didn't experience side effects. We also, not at the same time used Estrogen patches.

[rick8637]

Now I have read alot about e2 patches, and other estrogen gels. I have been on orgovyx and xtandi for 6 months with constant HFs every hour at night. I asked my MO and she said no no. I understood E2 was not available in US? Is there an over the counter gel which is available without prescription? How careful must one be with this stuff? Would love to try something that is safe.

[Derf4223]

Your MO might say yes to Venlafaxin 75 or 37.5 mg/day for HF management. Good luck

[Derf4223]

Do you have a Radiation Oncologist on your team? Your next step might include RT and Docetaxel. IDK -- I'm just a patient here and play a doc on TV (US joke.)

[CRPCMan]

Use the Honvan. It's the Holy grail.

[meowlicious99 in reply to CRPCMan]

curious. Why is it the holy grail ?