e2 patch

well I finally got to meet with y Oncologist last week regarding use of estradiol (e2) patch to battle against osteoporosis / osteopenia because the 90 day Xgeva dosing (down from every 28 daysx 2 years) doesn't seem to be doing much. He claims the possible cardiovascular side effects from the PATCH is not worth the risk. I'm confused, I thought the whole purpose for development of a trans dermal administration of the e2 virtually eliminated the cardio side effects. I like my team, but should I be concerned that he views e2 the same as oral estrogen? And, should I seek a second opinion....Xgeva hasn't prevented fractures, and my density is-2.3 in femoral neck and -1.5 in lumbar spine and hip.

Is it possible for the e2 patch to help strengthen and correct the bone loss I've already suffered from 4 years of ADT.

[GP24]

"I thought the whole purpose for development of a trans dermal administration of the e2 virtually eliminated the cardio side effects." This is the case. Maybe your wife can get the patches or gel for you. I expect the patches to avoid further bone loss but it will not recover what got lost in 4 years of ADT.

[FMOH_N]

I agree a second maybe a third opinion?

[Tall_Allen]

No need to change doctors. Just email him this, and ask for his comments. He probably hasn't seen it.:

thelancet.com/journals/lanc...

[Hidden in reply to Tall_Allen]

I referenced this article at my appointment last week.....he was unresponsive. I copied the link and emailed it to him, I'll wait for a response. It seems, according to the article, e2 is Much Less Toxic than what's been the standard

[Tall_Allen in reply to Hidden]

Having it in writing is always better. To be clear, E2, as a pill, is still problematic.

[podsart in reply to Tall_Allen]

whats your sense as to why more MOs arent using E2 patches; Dr Myers did for many years?

[Tall_Allen in reply to podsart]

I think patients have to show the evidence in writing.

[podsart in reply to Tall_Allen]

thanks

[EdBar]

When using estradiol patches the estradiol is absorbed through the skin and not the liver like estradiol pills. The liver is where clots are formed. I’ve been using patches for about 9 years now, originally prescribed by Snuffy Myers who has a couple YouTube videos regarding their use. My current oncologist Dr. Sartor has no problem with their use and said they are good for bone health.

Ed

[FourString]

It took me several tries to get my oncologist to prescribe E2 patches. Now he’s a believer. I had to play two cards to get him to sing along, tho: 1) I’ll sign a release form if you’d like; 2) I’d rather not, but do I need to find a new oncologist?

Btw, in my experience, E2 is not just for ADT or its side effects. My mets and prostate have shrunken to an extraordinary extent. Just like the research indicated. In fact, my urologist informed me last month that I no longer required the use of an indwelling or intermittent catheter!

[MateoBeach]

You are correct, Tommy. I would change doctors if he is not willing to read and consider the evidence as well as your preference. Looks like ignorance to me.

[petercraig2]

I provided my Oncologist with several Clinical documents on Estradiol patches, we had a discussion and he said yes 5 years ago with no other ADT Therapies.

My PSA and Testosterone are below measurable so technically in remission.

My GP/Oncologist got me a bone scan a year ago which was excellent, no indication of any bone loss at all.

Think you may need to find a new Oncologist as the fear of liver damage is non-existent with E. patches.

Problem for many Oncologists is Estrogen Patches are not prescribed Standard of Care so they are apprehensive.

[Hidden in reply to petercraig2]

I hate to think $$ plays a roll, but I would be naive to think otherwise.

What's your bio, what stage at diagnosis, any mets? psa gleason....etc

[Break60]

when estradiol was prescribed as an oral dose, it did have some cardiovascular effects. But when taken in the form of patches those side effects were no worse than other types of ADT. In fact the impact on bones was found to be less than ADT. Your doctor should read up on these studies. I’ve been using the patches since Feb 2019 and the side effects are much more tolerable than with Lupron and its ilk. The only real negative is man boobs which at my age I can tolerate.