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Estradiol patch prescriptions
I am on Lupron, Zitiga, and now radiation for a Gleason score 8 prostate cancer. The cancer had spread to adjacent lymph nodes and one seminal vesicle. Lupron, Zitiga and then radiation was prescribed as the standard of care. This regimen is making me feel awful, and from what I have read with continue to have harmful effects on my body.
Anyway, I recently found out about estradiol patches as an alternative to ADT. The estradiol patches actually increase bone density, and reduce hot flashes, blood glucose levels, and blood pressure. A major problem to some people is slightly increased breast growth. The most major problem for me is I couldn't find anyone to prescribe the patches. The PATCH trial in England has been testing Estradiol patches to reduce testosterone and therefore keep prostate cancer in check since 2007 (https://www.urologytimes.com/view/estradiol-patches-in-prostate-cancer-evidence-and-impact).
I finally have found a medical oncologist that agrees that this approach will likely be beneficial, but it wasn't easy to find him, and he may still have some difficulties prescribing this off-label. Wish me luck since I will not continue taking the ADT route.
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Hi all
I haven't been on this site for awhile. I left ADT treatment over 4 months ago and I am relying solely on estradiol patches to keep my cancer in check. I had a full course of radiation (28 days) and a TURP instead of a prostatectomy to ease my urinary problems. So far I am certainly feeling better, and my PSA and testosterone levels are undetectable for two months. I have been using three patches of 0.1 estradiol weekly. My last test for estrogen levels showed I have a level of 84. I am not sure if this is an adequate level or if I should have any changes to my prescription to raise these levels. Does anyone have some ideas as I am no longer with Dr Ng and can't get a clear answer from my local oncologist.
Thanks to everyone, and good luck
Gary Wade
@formscapeds
I’m not sure of the answer, but this site is designed to help people that have prostate cancer and use estradiol.
https://estradiolinitiative.org/
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1 ReactionHi all
I have a question that I am having trouble answering about the estrogen levels I should maintain to prevent recurrence of my PC. I posted this somewhere else but I am not sure where now. I finished my radiation on March 24, 2026 and quit taking Lupron and Zytiga in early March. I am just on 3 estradiol patches of 0.1 mg/day changed weekly. My last two blood tests showed undetectable levels in PSA and testosterone. YES! However, I now need to track estrogen levels and my local oncologist isn't sure what those levels should be. My level was 84, which is elevated but I am not sure is elevated enough. My oncologist said she would check it out, but I don't have an appointment for three months and I obviously don't want any further spread.
Anyone have experience with preferred estrogen levels?
Thanks, and I am feeling much better than on previous ADT treatment.
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1 ReactionI'm very interested in going on estradiol myself. I've been on Orgovyx for 7 months now.
The website Jeff referred you to is a high quality site. It has a section "Administration consideration for tE2 products" that cites the "official PATCH protocol" as a reference for clinicians. Refer your doctor to that.
In that protocol, "the aim was to keep the serum E2 level between 250 -2000 pmol/L (70 – 580 pg/ml). Medium E2 serum level observed was 790 pmol/L (230 pg/ml)."
The benefit as far as the "further spread" you are concerned about would come from the very low testosterone level the estradiol is producing.
Monitoring the E2 level is important to give an optimum relief from traditional ADT side effects such as hot flashes and bone deterioration, without leading to problems. Too much E2 can cause a number of problems.
A clinician aiming to get experience will be able to sort things out.
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1 ReactionIt is hard to find a doctor willing to prescribe the patch. The PHD/Dr at MSK (during my second opinion appointment) wouldn’t agree to it because it is not standard of care. My DC-area MO said only a few doctors in her department support it. The key is to find a doctor willing to work with a patient and listen to what is important to that patient.
I started the patch and radiation on o 6/17 and Zytiga/prednisone about a week later. I have 3 side effects: 1) Sore nipples and MAYBE slight breast growth (not a big deal), 2) a few bad days early on where I had slight nausea, stomach aches, which are now gone; and 3) a hard to describe pressure in my head that, when bad, made me want to sleep, which I did for several hours a day for 2 days early on. Every other day, the pressure disappeared almost as soon as I started biking.
Since I am the first patch patient for my RO and MO, they were unsure about the pressure. They correctly noted that with 3 drugs and radiation, my symptoms are had to disentangle.
Mrs. Surf (also on this thread) said it’s not a mystery. Pressure, headaches, migraines are common for women going through menopause due to their huge changes in hormones. Also, my body would likely would adapt to the big change it is experiencing (my T went from 350 to <3 in a month and my PSA is now <0.0006). She is right, as my symptoms have moderated significantly over the last week or so.
The Estradiol Initiative Jeff mentioned is incredibly helpful and responsive – just send them a message through their website. I am now in very frequent email conversations with one of them. Mrs. Surf—they may help find a West Coast doctor.
Good luck with your treatment. I hope you feel much better on the patch and that your treatment it a success!
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3 Reactions@surftohealth88
I have been on Estradiol patches for a couple months and am working with Dr. Ali Khaki, medical oncologist at Stanford Hospital in Palo Alto. An excellent and forward-thinking doc.
All best wishes and God bless!