Estrogen patches for PCa useage weblink pages of info-surprizing read

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Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 7/27/2010 1:21 PM (GMT -6)   
Here is the website info:
(inexpensive generally, can be done in gel form too,  way less side effects to none)
Benefits- bone density, memory, no hot flashes, no muscle ache or fatigue (unlikely), not associated with weight gain issues and others you can read up on. 

Don K.
Regular Member

Date Joined Jan 2010
Total Posts : 74
   Posted 7/28/2010 12:04 AM (GMT -6)   
Hi Zufus:
That was a terrific article with widespread implications to Pca patients.
How do we get this treatment line back into circulation?
It is my impression that DES was never officially taken off the market, but after the patent expired nobody was interested in supplying it. However DES is available from compounding pharmacys. Is this correct?
I would love to see you post an "executive summary" on this article because a lot of us get lost in the technical talk and you have a way of cutting through this stuff and getting right to the point.
Thanks again for bringing this up..
Don K.

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 7/28/2010 7:02 AM (GMT -6)   
First people would need to tell some of their docs I want this protocol or find an oncologist or other doc whom would support you in doing such and they are out there to find (there is no money in giving these to patients-fyi). Yep exactly DES has been around for 50 years, the drug companies used to make it but when there patent ran out and the new profittable drugs were coming out and available at the same time, what a coincidence for marketing.

Yes, DES is available at any compounding pharmacy, man made version, referred to as veterinary grade by some (FDA allows sale of this to probably you won't bark or grow a tail). I have used this for about 5 yrs. in 1-mg form and no problems and about no side effects, I would hate to think what I would feel and look like on ADT for 8 yrs. total. A leader with the group ( has been using estradiol (gel) or patches for 5 yrs. with excellent results, apparently, Dr. Fred Lee has been using emcyt (same category of estrogenic drugs) and for many years on himself as a patient. These drugs are mentioned in Dr. Strums book and some other books on PCa. Info found on them also at:  site.

Dr. Premoli in Argentina used estradiol patches almost exclusively on his patients. Patients in USA and other countries are using these and other drugs in PCa, there are choices and differences to consider. Those whom figure this kind of protocol is junk, fine no problem, remember to analyze what you are taking and its long term effects.

Don since you liked that weblink read this one real close, it is from the Journal of Urology Nov. 2003 (the Urologist mainstream publication-LOL) (Pro-DES)  

Summary- Found safe in patients in 1-mg, found more effective than LHRH or flutamides, found works well on hrpca, well tolerated, less side effects. Docs envolved state it should be highly considered as a return to use drug on PCa. (gee my uro-doc would tell me this choice even exists???) I did use ADT3 drugs for 2 yrs., so they made out well enough on me for awhile. I am saving the insurance company a fortune in payments, too.

Ketoconazole is another drug for PCa, interesting that it works, it was not even made for PCa, but found it had usefulness and is used by alot of onco-docs over the years now. It was approved back in the 1980's as a type of anti-fungal related drug (fyi). Should be used in conjunction with Predisone, see info on such.

Welcome to the world of PCa- lots to consider from all angles, any reasons we should question anything????   What happens 3 yrs. from now on all these things???
Does the focus change to saving money?

Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 7/28/2010 8:17:44 PM (GMT-6)

Don K.
Regular Member

Date Joined Jan 2010
Total Posts : 74
   Posted 7/29/2010 12:28 AM (GMT -6)   
Thanks Jufus.
The reason I am interested is because I've been on ADT2 (Lupron plus Casodex) for 10 monthes and the doc ageed to let me have a vacation from the Lupron (continuing the Casodex however).
The ADT brought my PSA down from 38 to 0.53 where it is now.
I know that sooner or later I will go refractory and need to start thinking about another route.
Not sure my Pca Onco will consider DES but will ask him next visit.
Thanks again for the great you do on the site...
Don K.

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 7/29/2010 7:09 AM (GMT -6)   
Don thanks for your asking questions, there are no dumb questions on life and quality of life. I have to tell you from my experience and seeing others do ADT2 or ADT1 etc.
Your lowest psa level is the .53 while on these? Over a ten month time usually we see patients with even lower numbers, some show around undectable levels(that is the goal).

So not trying to put fear into you, but do you realize in comparison the possible significance? It is your decision how to approach fighting this, many docs won't mention or wish to prescribe estrogenics and yours may say no, which would not surprise me, and the docs usually talk about blood clots and dvt's (old school from 1950's patients given 5 mg and without aspirin or blood thinner and some got clots V.A.-Vacburg studies), most all got good results otherwise and used for decades) as Journal Article says 1-mg is safe to use and works on hrpca. Similar or better said about estradiol patches, emcyt may have more possible side effects but is another choice in this group. Ketoconazole your doc might consider, use Prednisone with it, have to watch monitor liver when using this one, some people have effects and others don't mention real issues using it. Works on hrpca, how long is the next question?

I would guess you already are dealing with some hrpca based upon your response to ADT2 at 10 months out, so looking ahead is not a bad idea, and gives you time to compare opptions. Your 'T' level could rise while being off Lupron, may eventually effect your psa level, so keep an eye on such. Some docs are saying off cycle a patient could wait till psa reaches 10.0 or arbritary place in between, maybe even 15.0 and docs in Canada are even saying psa level of up to 20.0 before resuming or adding drug changes. While one is maybe considering doing this, watch your doubling times and velocity time to get to that level and that could be a major clue. This is a gray area in oncology and because PCa is undefinable as to how aggressive in a particular patient, makes it this wild as to when and what. This is why artists in oncology as specialists in PCa are worth considering for ones case, they know the potential of various drugs, have patient clinical experiences and probably read everything on PCa and with an open mind.

Be vigilent on your own case if you can, of course there are choices of non-vigilent too.
Thanks for the kudos, some would disagree of course.
Youth is wasted on the Young-(W.C. Fields)

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 7/29/2010 9:32 AM (GMT -6)   
Prednisone itself comes with a lot of potental "damaged" goods. While the drug obviously is in wide use for a number of reasons, it has been linked to extreme mood swings, sudicical thoughts, unstable behvavior. There have been prednisone cases where users have even murdered under its influence. I was put on it about 20 years ago for a shoulder injury, and the dr. never told me a thing about it. Terrible experience, first night, had to go to ER, as we thought I was having a heart attack, had all the symptons. Was only on it a total of 5 days, and it took me probably a year or two to get over its influence and damage. Perhaps just one bad example, but I am telling you what it did to me. Back then, Time Magazine did a whole article on how dangerous a drug it really is.
Age: 58, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one: Aug 3
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 - 17 days, Total Blockage, Cath # 20 - 7/19

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 7/29/2010 2:28 PM (GMT -6)   
Didn't hear that before, I don't think in the doseage and with combining with Keto for PCa we have such bizarre reactions that are heard about, but don't know all about this protocol as docs should. I have seen others post on forums whom used this with Keto for PCa and had no big issues with it, or maybe a few that had some side effects, but never heard dramatic events. Not doubting what you say on that drug, alot of variables as to doseage, combining, and type of patient chemistry subjected to such. You do have wonder about a doc that doesn't tell a patient on possible side effects, especially if they are as heavy duty as you mentioned (that reachs lawsuit level for non disclosure), perhaps.

Good to question what side effects on any drug and they should be known about, some of the drugs on t.v., right now even mention unpleasant side effects like could be fatal or cause cancer or such, right in the add. Yeah take a drug for a minor ailment, whereby it could be fatal and such (LOL)??? It is crazy out there!
Youth is wasted on the Young-(W.C. Fields)

Veteran Member

Date Joined May 2008
Total Posts : 1010
   Posted 7/30/2010 7:59 AM (GMT -6)   

Good disussion and information. Like you my doc never mentioned estrogen or any form of it. He did mention the Ketoconazole and prednisone. My ears sort of perked up when I heard prednisone. Like David I have read some rather disheartening things about this substance. I have been looking for a medical oncologist locally to take up management of my case butno luck so far. To complicate matters I am looking at relocating to a warmer climate if the housing market improves. My situation is similar to Don K's.

As far as the DES I have only been able to find it for vetrinary use. As you suggest I have decided to bark next time I see the doc. :)

Again, thanks for some very good reference material and useful information.

Don 826
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Two years on Lupron completed 01/2010.
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 were full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones
PSA 05/10 .42 Rising a little as the lupron wears off. Last lupron shot 01/10.
PSA 06/10 .322 Maybe the .42 reported in May was in error?

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 7/30/2010 2:41 PM (GMT -6)   
Thanks Don, maybe go the estradiol gel(or patches) route like Chas. M from is using, he stated he has 5 yrs. on using this, maybe contact him and ask about side effects (probably boob tenderness is the only one). Others I have talked to using DES all got results on psa drop, it varied alot as to how long because of their disease levels when starting on it...they all got the vet grade and no howling at night on it (LOL). However lifting of leg around firehydrants was a side effect (LOL). Prices do vary by location or seller.  HERE IS ANOTHER STUDY ON ESTRADIOL PHASE II-(took if off of hrpca post by H.H., so as being a member and sharing it here):
Phase II Study of Low Dose and High Dose
Conjugated Estrogen for Androgen Independent Prostate Cancer
Mark Pomerantz, Judith Manola, Mary-Ellen Taplin,* Glenn Bubley, Margaret Inman,
Jennifer Lowell, Clair Beard, Philip W. Kantoff and William K. Oh†
From the Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School and the Beth Israel Deaconess
Medical Center, Boston, Massachusetts
Purpose: Although estrogens have known antitumor activity in androgen independent prostate cancer, the best studied agent, diethylstilbestrol, is no longer commercially available in the United States. We tested 2 doses of the conjugated estrogen Premarin® in patients with androgen independent prostate cancer to determine the efficacy and safety of this widely available medication.
Materials and Methods: A total of 45 patients with progressive androgen independent prostate cancer were randomly assigned to receive Premarin 1.25 mg once (17) or 3 times (28) daily. Warfarin 1 mg daily was administered to all patients to minimize risk of thromboembolism. Low dose prophylactic breast irradiation was administered to most patients. Results: Of the patients receiving high dose Premarin 25% achieved a 50% or greater reduction in prostate specific antigen.
No patients treated with low dose Premarin reached a 50% reduction in prostate specific antigen. After 3 months of treatment, 11 patients (39.3%) on the high dose arm and 6 patients (35.3%) on the low dose arm showed no signs of progression. Three patients (6.7%) had a thromboembolic event. No significant gynecomastia was noted. A significant difference in dehydroepiandrosterone sulfate levels was detected between those who did and did not respond to Premarin (p 0.03).
Conclusions: High dose Premarin resulted in prostate specific antigen decreases of 50% or greater in 25% of patients with androgen independent prostate cancer. More than a third of patients receiving high or low dose Premarin maintained stable disease for at least 3 months. With concurrent warfarin 1 mg treatment, 6.7% experienced thromboembolic complications. Premarin 1.25 mg 3 times daily is a reasonable therapeutic option for patients with androgen independent disease.
(last line therein speaks out)

Post Edited (zufus) : 7/30/2010 2:17:07 PM (GMT-6)

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