Estradiol Patches use in Prostate Cancer: Evidence and Impact

Started estradiol exactly two weeks ago. So far, only noticeable side effect has been skin irritation from the adhesive.
Will have my testosterone checked at the end of the month. I am also on Nubeqa, which I started six weeks ago. No obvious side effects from that.
My experience with Eligard was hot flashes and the development of osteoporosis.

Please continue to share your experience. This should become commonplace. From the PATCH and STAMPEDE studies, Estradiol patches are equally effective as standard ADT with way less side effects.

More info here from a medical scientist and a past President of the Urological society. Both have metastatic cancer and have been on ADT and the Estradiol patches. The first has been on the patches for 22 years. The urologist 18. Virtually no side effects and still kicking.
I am not allowed to post a link but go to the urologytimes website and search for: patches-in-prostate-cancer-evidence-and-impact for five videos of the Dr. and scientist discussing their own experience.

You can also look-up the PATCH trial which just concluded in May of this year.

Tons of videos on YT as well about this.

I started radiation and the Estradiol patch on 6/17 and Zytiga and prednisone on 6/26 for post-RALP BCR. I was persuaded by all the people and trials Marko cited above. The two people he is referring to (Richard Wassersug and Dr. Shellhammr) created a website call the Estradiol Initiative that compiles a lot of the data and information on the patch.
Be aware you will face some resistance if you want to go this route. When I got my second opinion from a MO in Sloan Kettering in NY, he flat out said he couldn't support the patch because it was not standard of care and there was not enough long term data to support it. My MO (Dr. Paller), who prescribed it for me, said only 2 of 10 doctors in her department supported it.
I had had some strange side effects (occasional head fog, extreme fatigue, stomach aches) that I was inclined to believe were from the patch due to the timing of these symptoms and when I put on new patches, but I no longer believe the patch caused them. I am Dr. Paller's first patch patient so this was new to her. Her team pointed out that these symptoms were not reported in the PATCH or STAMPEDE trials. I contacted Richard Wassersug and Dr. Shellhammr through the website. They were very responsive and agreed these symptoms were not reported in the trials. They do not believe its from the Patch and pointed out I am on 2 other drugs and in the midst of radiation treatment so it's hard to sort out what is going on.
I am not telling you this to scare you off the Patch--I am still a firm believer. While I have slight nipple soreness, I have had no hot flashes, exercise almost immediately resolves the symptoms, I can still bike a lot and I can still lift the same weights that I lifted before treatment started. And, as I said, my symptoms are unique.
Most importantly, everything is working. My first blood test results post treatment: PSA is <0.006 and T is <3.

I live in Oregon and contacted OHSU (the only NCI center in the state) and found a medical oncologist named Dr. Ronald Ng who is already prescribing Estradiol for PC. The contact PA for the multidisciplinary team is working hard to promote my case and desire to use a prophylactic RT dose and Estradiol patches as my ADT. Uphill battle but we are both hopeful.
My situation:
77 y.o.
TULSA PRO ablation 7/2026
Stage 4 metastasized to two pelvic lymph nodes
Cribriform, PTEN loss, ERG, intraductal, neural invasion
Gleason 4-3 (90%) and 3-4 40% bilateral in prostate
Decipher score: .92

No side effects after TULSA PRO. Had a catheter in for 7 weeks (BPH 5weeks before - couldn't void without a catheter; 3 weeks after TULSA PRO because of very large prostate volume of 158cc). Slight spotting but no issues with infection, ED, incontinence, bladder control and BPH 90% improved.

My plan is to get SBRT on the two lymph nodes along with Estradiol for 3-6 months and see what the outcome is. Am told it will be at least a month or more before there is any chance of meeting with the multi-discipline team at OHSU.

NO INTEREST IN ADT. There is evidence for not using ADT with SBRT (cf STOMP and ORIOLE trials) but difficult to find centers that will actually do this. Called MDT.

Will post as I learn more.