DES / estrogen

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Hi, Regarding DES (short for diethylstilbestrol?), I am interested in RJ's comment regarding oral vs. dermally taken estrogen - I have not heard the argument about dermal estrogen being safer for blood clots because it doesn't pass through the liver like oral estrogen. Could you point me to more information on this? The comment I would add is that the FDA has been looking at this issue because of reports of deaths from the birth-control patch, Ortho-Evra (which contains versions of estrogen and progesterone). In the case of the birth-control patch, the FDA ended up putting a warning on the patch that users of the patch may be exposed to more estrogen than pill users and be accordingly at higher risk of estrogen-related side effects. (Which is why I'm interested in the liver-pass argument, as I did not read about that being presented as an argument for the patch's safety.) Best,

TheaProstateCancerSupport wrote: Message: 5 Date: Wed, 8 Feb 2006 18:47:33 -0600From: "RJ" Subject: Re: more on fpsa test and results.Hi Sam,Terry is right on about DES , however let me add that Estradiol Patches are reported to be safer from Thrombosis (blood clots) because the Estrogen is absorbed through the skin and never passes through the liver which is the case with oral DES. It is believed that oral estrogens are higher risk for blood clots for that reason and that is why the patches are safer. But on the down side, Dr. Israel Barken reports that Estradiol Patches are somewhat less effective than Oral Estrogen. However, I'd be inclined to try the safest path first---indeed that is what I am seeking by shopping various doctors, because both solutions are about

one-tenth as expensive as conventional Hormone Therapy for PCa. The "catch" is trying to find a doc who will prescribe Estrogen therapy because the docs are worried about liability if you get a blood clot. I'm hoping to find a doc who will allow me to sign a waiver or release that will remove his/her risk of repurcussions.Best wishes to you my friend, as we plod along through the darkness of this disease and the many paths we have to choose from.RJ RE: more on fpsa test and results.Thanks Terry I'll look into it.Terry Herbert wrote: SamI came in late to the discussion, but if you're out of money and insurance and you need a cheaper option to control late stage PC a then you should be looking at DES. It is not easy to obtain,

but not impossible and the cost per month is in tens of dollars, not thousands. You have to be aware of the potential using this has for causing thrombosis, but that can be dealt with by using warfarin, another drug that is down the scale in costs.All the bestTerry Herbert

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