My husband has been taking Effexor for hot flushes and it does not seem to be effective any longer . He increased the dose from 37.5 to 75 mg and that did not seem to make a difference. He has been off Effexor now and the oncologist is saying to try the low dose Estradiol patch . To be honest we are both scared of the fact that he is doing triple therapy to beat down the cancer and adding a hormone back into the mix when prostate cancer is hormone based?? I really want everyone's honest options about if it is at all risky? Is enough even known about it yet? Does it cause other issues and side effects? But the big question is will it possibly wake the cancer up sooner if it was not taken. When I called the pharmacist who I do find knows a lot more than most doctors about drugs , she was really sceptical about if enough info was out there to know for sure. Any thoughts or info would be so helpful from all of you. Thanks so much. He finally is 7 weeks past last chemo and his PSA numbers are going in the right direction, I'm very scared of this rocking the boat .
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Estradiol suppresses testosterone production, so that isn't much of a concern. In addition to hot flashes, it prevents bone mineral loss, emotional lability and loss of lean body mass. But you are right that the full data are not in yet. Other medicines that may help are Megace (another steroid), and oxybutynin (used for bladder spasms). There are data that aural acupuncture can be effective -- maybe worth trying.
In the US, the FDA has approved Veyozah in post-menopausal women. I know a man who is using it, and it has almost completely gotten rid of his hot flashes. It works on the thermoregulatory mechanism and isn't a steroid and doesn't affect emotions.
I respect the knowledge you have and I'm very confused the more I research this. One article says that prostate cancer can feed off of estrogen and another says there is no proof. In your research have you found this to be a drug that has too much risk? The urologist is highly promoting this and our own doctor says that cancer only feeds and grows from testosterone, but some articles say different? What's your thoughts ? Thank you for your reply
Patients should consider lab tests to be Internet garbage - only clinical data matters. Patches are being investigated as a replacement for ADT. So far reporting is that it is safe and suppresses testosterone.
Thanks for the response. My husband does not want to replace ADT. He is just considering a low does 0.025 patch for hot flushes . He is still having great numbers from his treatment he is on but trying to get rid of the hot flushes and it seems the medications he has tried are not doing a good enough job. Thanks for your response
I tried 6 different treatments for epic Hot Flashes. When the women's post-menopausel drug came out - VEOZAH - I gave that a try and it has been a Huge game changer for me. I no longer sweat though 3 tshirts a day and need to change to change the sheets every morning. However it's expensive as it's not yet approved for men by insurance.
I really dont know about the breast increasing in size, I'm not sure about much with this patch and trying to find others that are on the low dose and get as much info as I can in case my husband decides he want to try for the brutal hot flushes
Yes, it certainly can. I have been on low dose E for 18 mos now, current dose 0.75/wk. Yes, I started developing man boobs and nipple sensitivity early on. It continues, but growth seems to have slowed. Each man is different.
I have mercifully been spared the worst of the hot flashes, so I do not know its effect on them. I started taking it after suffering a collapsed vertebrae, because the ADT and the prednisone were destroying my bone health. That has improved, although I am not sure exactly what role the estradiol has played. But yes, I will take man boobs over another spinal fracture any time.
i have been on veozah for 4 weeks and it’s a lifesaver. It’s a new , non hormonal hot flash medicine. (It’s only approved for women) I have a few Obgyn friends who gave me samples but my wife’s doctor said she could prescribe for her and i would just “borrow it”. My docs approved its use. It’s $500 per month without insurance coverage otherwise.
I’ve been using estradiol patches for close to 10 years now, they work like a charm on eliminating hot flashes and help with bone health, they may also contribute to overall treatment of prostate cancer. There’s nothing to fear, there’s no cardiovascular risk with the patches either since they are absorbed through the skin and not the liver like the pill form is. Dr. Snuffy Myers originally prescribed them for me he has some videos on YouTube regarding them that you can check out. My current oncologist, Oliver Sartor at Mayo also supports their use.
Thanks so much for all this information, the internet has made me so confused. Also one doctor says yes another no. My husband is still Castrate sensitive and PSA has slowly been going down . ( have numbers in profile ) Some sites even talked more about being castrate resistant , which he is not. We just are being cautious and making sure this is not going to have some sort of negative reaction to the treatment he is on or the cancer. Thanks for your reply. Best of luck with you
Both Dr. Myers and Dr. Sartor are among the leading doctors in the world when it comes to prostate cancer (Myers is now retired). I credit Myers for a treatment plan that I continue with today, 10+ years after a Stage 4, Gleason 9 diagnosis. That and a lot of prayers for Gods healing hands.
He is uninformed, there is a blood clot risk from the pill form because it is processed through the liver, but the patches are absorbed through the skin. Watch Snuffy’s videos on YouTube, he explains it in detail.
I'm wondering if you had any issues with the breasts ( breast increase /pain )? If so how did you correct this ? Also my husband has a higher chance of breast cancer due to the BRCA2 gene mutation and I'm wondering if you think this will also increase that risk ? Appreciate your reply's and knowledge .
No pain but some gynecomastia, but that could also be attributed to ADT and age but it’s not a big deal, I just wear loose fitting shirts or compression tee shirts under a shirt. I don’t really worry about it, when I’m at the beach I’m probably in better shape than most my age. And it sure beats the extreme and numerous hot flashes I would get. As for breast cancer, I have no idea but I’ve never heard of estradiol being a contributing factor, but I’m not a doctor, just sharing experience and what has worked for me.
Low dose Estradiol patch worked wonders in getting rid of my hot flashes. Yes I did get an increase in breast size. No big deal, most people don’t even notice. Small price to pay for relief. It doesn’t cause any embarrassment to me. It’s whatever your frame of mind is. When it comes up and that’s nor very often, it gives me a chance to inform others about Prostate Cancer.
I agree with everything that's been posted so far.
The UK PATCH study started 15 years ago, and it involves over 2000 men at 52 centers. They have published many detailed preliminary results, and none of them have mentioned increased rates of breast cancer. Some percentage of men experienced moderate gynecomastia, but no increase in blood clots. That is because the transdermal application bypasses the liver first time around. The MO that advised against estrogen therapy is thinking about oral estrogen (Diethyl Silbestrol) that was the only drug available from 1950-1980 to chemically castrate men before Lupron was invented in 1980. DES did cause increased rates of blood clots. But, no increased rates have been found in estrogen applied transdermally (by patches, gels, creams, pellets, sprays, IM injections, etc.).
The other thing to recognize is that the estradiol dose in the PATCH studies is 16 times higher then the dose you are considering. You are considering a small patch with only 0.025 mg of estradiol per 24 hrs. The PATCH study used four, large, 0.1 mg E2 patches/24hr, applied simultaneously, for a total of 0.4 mg E2/24 hr. That is 16 times the dose you are considering. So, I would categorize your dose as being "Very-Low", and I worry that it won't be sufficient to relive the hot flashes and reduce osteoporosis.
You can certainly start on a very-low dose, but don't be surprised if you need to apply more patches at a time (or buy larger patches) to get a strong enough response. The costs of estrogen patches is very low, compared to other drugs (Veozah @ $ 500/month), and Veozah doesn't treat osteoporosis. Plus, estradiol is an all-natural hormone that is made inside the body by aromatase conversion of testosterone to estradiol.
Another point to consider, if high-dose transdermal estradiol (TDE) had increased the rates and severity of prostate cancer, the PATCH trials (Phases I, II, and III) would have been stopped more than 10 years ago. But, there's been no reports of increased PCa with TDE.
I've talked to the lead researcher, Dr. Ruth Langley, of the PATCH trial, and she assures me that the 10-year survival data will be published this Fall. If you send me a request to my email, janebob99@lobo.net, I will send you some of the best papers about transdermal estradiol.
Hot flashes having been the most awful side-effects of ADT for me over the past 8 years, and any kind of estrogen meds causing hideous ankle swelling and breast growth and pain, I've been using Chinese herbal medicine. And although it does not stop them, it makes them noticeably shorter and less intense. I live in Japan where that med is not only readily available but is also covered my health insurance. There are many, many herbal hot flash remedies available on Amazon, though, I've noticed, so I'd recommend checking some of those out. Hope this helps.
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