Radiation for ADT-caused gynecomastia

[duckcalldan]

I started 24 months of Orgovyx and Nubeqa back in October. And I completed 28 fractions of IMRT two weeks ago. I have noticed a not-insignificant case of gynecomastia that has progressed over the past month or two. No tenderness associated with this by the way.

After meeting with my MedOnc last week and describing my symptoms, he recommended reaching out to my RadOnc about radiating my breast area. Here is his response:

“Radiation to the nipple area for gynecomastia prophylaxis was done a lot back in the day, mostly when guys were receiving casodex without lupron/eligard or other forms of testosterone suppression. The risk of gynecomastia with testosterone suppression is low, and I haven't had to do the radiation for this in a long time. That said, it is pretty effective and there are a few different regimens. Typically I'd do 3 treatments which is very safe and easy to do. It's certainly better as a prophylactic treatment so if you want to consider it let me know and we can get this knocked out pretty quickly.”

Any thoughts or recommendations? Downsides? I’d like to get this done within the next few weeks if possible. My max out of pocket is met so this won’t cost me a cent.

[Tall_Allen]

Tamoxifen is much more effective than chest radiation:

thelancet.com/journals/lano...

Now with transdermal tamoxifen, the risk of blood clots is minimal:

bayviewrx.com/formulas/Tamo...

[duckcalldan in reply to Tall_Allen]

The Lancet article you referenced mentioned gynecomastia specifically caused by taking casodex/bicalutamide. Would tamoxifen be just as effective on my gynecomastia caused by a different medication?

[Tall_Allen in reply to duckcalldan]

Yes.

[duckcalldan in reply to Tall_Allen]

When I Google “transdermal tamoxifen”, the only result is Bayview Rx, the compounding pharmacy on the East Coast you reference. Is it possible to obtain it locally or close to home near Seattle? Bayview doesn’t ship outside of New England.

[Tall_Allen in reply to duckcalldan]

How about this one:

empowerpharmacy.com/compoun...

They say they ship everywhere:

empowerpharmacy.com/compoun...

[NanoMRI]

'back in the day - seven years ago I had radiation prior to my one year of Casodex.

'it is pretty effective' - well, if it was for me, I dread the thought of what I would look and feel like if I had not done the radiation. Or, a different perspective, radiation did not work for me.

[SteveTheJ]

AFAIK, radiation causes scar tissue. 10mg tamoxifen isn't a cure but it's made mine less painful. YMMV

[Teacherdude76]

Had it... Worked

[j-o-h-n]

Guys who's Dicks Mix with their Tits, don't Click with Chick's and their Kicks.....

Good Luck, Good Health and Good Humor.

j-o-h-n

[PCaWarrior]

Whatever you decide, you need to decide before the breasts take root. If they grow supporting blood vessels they can be very hard to get rid of. Talk to your MO about the timeframe.

[Mgtd]

RO give me the pill. She said it worked better.

I also increased chest work at the gym to tighten the chest and build muscle. This seemed to offer some help in the physical appearance category.