Nubeqa (Darolutamide) versus Zytiga versus Estradiol Patches

Does anyone have experience with these two drugs?

My partner was recently prescribed Zytiga along with Orgovyx plus a 7 week radiation treatment.

I have read that Nebeqa may have less side effects and therefore asked the MO if she could change the Zytiga to that. She replied and said, “ Darolutamide/Nubeqa is not approved in this scenario. (And it's never been shown to be better or have fewer side effects than abiraterone/zytiga).” I’m not sure what the scenario my partner has that wouldn’t allow for him to have it and I of course will wait to ask her more questions in person as this was all through messaging portal.

My question is, are these two drugs not somewhat the same thing? I know of course they’re different but wanted to know if anyone knew why he wouldn’t be able to take it.

I also asked about the possibility of him taking Estridiol instead of ADT and her reply was, “ I have used estradiol patches, it has its advantages but does increase risk of thrombosis (blood clots) so I haven't used them together with radiation. There is also of course more breast side effect (enlargement and sensitivity). So they are a good choice for some but not all.”

I’m somewhat disappointed I guess as I had hoped he could take the Nubeqa instead. I have read a fair amount on it and most what I have understood is that it seems to be better tolerated.

Does anyone have experience with using Estradiol patches instead of the ADT route?

Thank you for any advice or tips. I’m just trying to navigate this whole situation the best I can with the most knowledge.