Estradiol for the mitigation of adverse effects of ADT.

[pjoshea13]

New Australian paper below.

It's not clear to me why this paper wasn't written ten years ago.

"Recently it has become apparent that many of the biological actions attributed to androgens in men are in fact not direct, but mediated by estradiol. Available evidence supports a primary role for estradiol in vasomotor stability, skeletal maturation ..."

"Potential role for estradiol could be ... as low dose add-back treatment while continuing androgen deprivation therapy."

-Patrick

ncbi.nlm.nih.gov/pubmed/286...

Endocr Relat Cancer. 2017 Jun 30. pii: ERC-17-0153. doi: 10.1530/ERC-17-0153. [Epub ahead of print]

Estradiol for the mitigation of adverse effects of androgen deprivation therapy.

Russell N1, Cheung AS2, Grossmann M3.

Author information

1

N Russell, Endocrine Department, Austin Health, Heidelberg, 3084, Australia [e-mail].

2

A Cheung, Medicine, The University of Melbourne, Heidelberg West, 3081, Australia.

3

M Grossmann, Medicine, University of Melbourne, Heidelberg, 3084, Australia.

Abstract

Prostate cancer is the second most commonly diagnosed cancer in men. Conventional endocrine treatment for prostate cancer leads to global sex steroid deprivation. The ensuing severe hypogonadism is associated with well-documented adverse effects. Recently it has become apparent that many of the biological actions attributed to androgens in men are in fact not direct, but mediated by estradiol. Available evidence supports a primary role for estradiol in vasomotor stability, skeletal maturation and maintenance, and prevention of fat accumulation. Hence there has been interest in revisiting estradiol as a treatment for prostate cancer. Potential roles for estradiol could be in lieu of conventional androgen deprivation therapy or as low dose add-back treatment while continuing androgen deprivation therapy. These strategies may limit some of the side effects associated with conventional androgen deprivation therapy. However, although available data are reassuring, the potential for cardiovascular risk and pro-carcinogenic effects on prostate cancer via estrogen receptor signalling must be considered.

PMID: 28667081 DOI: 10.1530/ERC-17-0153

[aksns61]

Here is a National Institutes of Health (NIH) paper presented in 2012 discussing the results of several studies using a variety of products to reduce hot flashes in MEN. There is a downside; de-masculatization expressed as increased breast size (17%) and other undesirable impacts when using Estrogen or Estrogen similar products.

ncbi.nlm.nih.gov/pmc/articl...

My docs thought the risks outweighed the benefits, therefore I decided not to use Estrogen, even though it was offered. There are new meds in the pipeline, significantly safer, and when they pass the phase II efficacy trials will go into production and distribution in 2018-2019.

Alan

[pjoshea13 in reply to aksns61]

Alan,

Did you have your estradiol [E2] level checked? With E2<12 pg/mL there will be bone issues.

-Patrick

[aksns61 in reply to pjoshea13]

Ans... they may have. I have annual bone scans- all were fine, and calcuim, etc levels all fine. As a rugged hiker, bones and muscle are OK. I take Vitamin D on advice of my GP.

[pjoshea13 in reply to aksns61]

Alan,

Don't forget the vitamin K2. It is important for calcium transport to bone, but it also has anti-PCa properties.

Have you tested vitamin D levels?

-Patrick