Tall Allen- that is one of negatives but not that huge of negative, unless you get those huge breasts (lol), first of all not everyone is subject to boob enlargement (Dr. Myers mentioned some guys 30% or so never get enlargement no matter what drugs they used and nobody knows why that is), casodex even avodart etc. mention boob enlargement too as possible, and Ohio State-Andrew got some enlargement on using casodex). As Tall says, you can elect radiations to prevent future growth of which I had done and it basically worked (can be done with electron rays in 1-4 sessions-fyi), or drugs like tamoxifen and another could be used as prevention. Some guys whom got enlargements while on casodex, especially if taking high dose casodex (100-150 mg), could later on have breast reduction (not a fun concept) but some have chosen that option.
Myself had more mood changes on ADT3 than when using DES or estradiol patches.
Dr. Premoli in Argentina uses estradiol patches as standard treatments on patients with great successes, no blood clotters happening and no DVT's patients, which is possible to achieve. There can be a small number of high risk clotter type patients whom might be subject to dvt's, simple INR-Protime blood clotting testing can help screen ones risk, then if needed one could use aspirin or coumadin to prevent those less likely events. I know of only one case where a man on a forum got a dvt using patches, and his leg swelled up and went to hospital and got it handled....he was one of those high risk types and was not properly screen up front.
As to how much do they prescribe, my friend Doug has done extensive testings while on the patches to figure what doseage worked best for his particular case. The patches come in doseages of .025+ and even 1.0 (I think is the highest). Now you may need to wear 3-5 patches to get the best results as Doug found out, starting with lower number then adding patches. They can come off, showering can be part of an issue using them (you can try putting tape over them or other ideas for less water getting onto them, some water on them you can get away with, I am using a patch now myself and know so). Brand names are: Climara, Vivelle, Mylan and others and generic, you can even get clear see through patches which I like best thus far, stick pretty good and not as large as Mylan. Coming down the pike will be customized estradiol gels (which Doug found a pharma here can do for patients) and perhaps customized patches will be introduced soon, so as to wear one patch vs. 2-7 or some such numbers people are using.
So, why isn't this used more on patients, well it is gaining traction more and more and as patients realize or demand a chance to try them. What the blank is casodex and LHRH drugs, health food (?) and have no side effects? LHRH taken long enough can ruin your memory and bone density and maybe assist bone fractures, not exactly mentioned much up front to patients. Do you notice medical field will never mention anything useful for any ailment that is natural, unpatented, herbal, home remedies and along that line of thinking. So, like you say Mel.....'why is that'???? Why isn't pathology directed to only the best experts and have added testings for the AR receptor or molecular tests that could be done or is it more important to just categorize patients as you have PCa and we can treat it, let's start today? It is a perfect world (yes, maybe, no, or maybe so).
Post Edited (zufus) : 3/7/2013 4:36:42 AM (GMT-7)