Hormone Therapy

Actually, I have talked about the patch trial a lot. I frequently tell people this is an option when they say that ADT is causing them problems. People who have heart issues are probably the most likely users of estrogen rather than ADT.

I have posted this previously

The patch trial Completed in England and showed that estradiol worked just the same as ADT, but had many fewer side effects. It’s easier on your cardiovascular system, On your bones (osteoporosis), causes fewer hot flashes and less brain fog. If your doctor has not heard of the patch trial, there is a lot of information about it so come back and we can help you.

I agree that exercise certainly helps - no doubt about it. But I've also been considering adding low dose estrogen.

Why? My current estrogen level is "undetectable" and that doesn't seem healthy. Perhaps adding a small dose of estrogen would (1) help me feel better and (2) aide my overall health. Heck...I've even read that estrogen had been used as a form of ADT many decades ago.

I'm thinking if I added estrogen and closely monitored my levels (to avoid gynecomastia in case my estrogen got too high), this could be a nice "win-win" scenario.

As long as you do not have BRCA low dose estrogen can increase desire, which is desirable!! It also can have other benefits like fewer hot flashes and less bone loss. However, estrogen therapy also carries its own set of potential side effects, including cardiovascular risks, breast pain or enlargement, and changes in cholesterol levels.

The Patch trial completed and found that estrogen worked as well as ADT to Reduce testosterone with prostate cancer patients.

You're right, but someone on this forum described exactly the way I feel on Lupron (awful) and said he had gone to one month injections of about 7 mg as opposed to three month injections of about 22 mg. He said it has made all the difference in energy, depression, etc. It's getting the 22 at once that puts me in the dark pit for three weeks to a month.
I asked Mayo about it and they said it is an option so I will start on it in August.

Thank you Jeff.

As it turns out I completed a free prostate cancer genetic test from Color.com this morning. This should let me know in several weeks whether I have a BRCA mutation.

Although I haven't studied this subject thoroughly, I'm aware men need some degree of estrogen. I'm thinking having at least a small amount -- something more than being "undetectable" -- should be helpful for nearly all men.

I will definitely monitor my estrogen (i.e., estradiol) levels and try to aim for the older male reference range of 15 to 25 pg/mL. The benefit may not feel significant but I'm willing to give it a try. It seems like a conservative move with more upsides than downsides.

I've not had significant brain fog issues in 6 months on Orgovyx. I am having hot flashes, lowered libido, erectile dysfunction, weight gain, and a lot of fatigue. My best antidote to fatigue is exercise. My PET scan showed both prostate and lymph node involvement so I'm scheduled to be on Orgovyx for 24 months. I'm hoping to convince my oncologist to switch from Orgovyx to Nubeqa at 12 months to lessen side effects and prevent Castrate resistant Cancer. All the best!

You could ask the doctor to switch from ADT to estradiol patches (or jel). The patch study showed it’s just as effective as ADT, but has many fewer side effects with fewer hot flashes, and it does not affect your libido nearly as much. That would be a lot safer.

You could almost definitely safely stay on Orgovyx for two years without worrying about castrate resistance. A little unusual for it to happen that quick.

What I’ve read suggests castrate resistance at 18-20 months . Not so?

Stats I’ve seen showed 2 to 3 years typically but up to nine years. I guess 18-24 months would work.

I don’t know if it really is all that important to not be castrate resistant with the drugs we have today.

Hot flushes occur in 60% +patients,bone loss, muscle loss,foggy brain
All these can be controlled with low dose estrogen. estrogen is not a medicine dear.its always there in the body but adt destroys it as well .and I am talking of low dose
Tamoxifen and raloxifen are other options