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Paul Edwards

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Luteinising hormone-releasing hormone agonists (LHRHa) or antagonists are used for Androgen Deprivation Therapy in men with advanced prostate cancer.  These include Zoladex, Lucrin, Eligard and Firmagon.


Oral estrogen (eg, diethylstilboestrol [DES]) was previously used for Androgen Deprivation Therapy before the development of LHRHa drugs.    Oral estrogen ceased to be used for Androgen Deprivation Therapy because of cardiovascular  toxicity (damage to the heart).  The cardiovascular  toxicity was caused by the way that oral estrogen was metabolised in the liver.


If estrogen is administered intravenously, by injection into a muscle or transdermally (using patches on the skin), it is metabolised in a different way from oral estrogen.


Scientists believe that administering estrogen in this way could avoid the cardiovascular toxicity that occurs with oral estrogen.  They are conducting a large clinical trial (PATCH) in the United Kingdom to see whether this is correct.  If it is correct, then estrogen might be a much cheaper method of Androgen Deprivation Therapy with less side effects than the very expensive LHRHa drugs.


A study was conducted of some of the men participating in the PATCH trial to examine whether estrogen and LHRHa drugs had different effects on bone mineral density.


Click on this link to read a report by Malecare on this comparison of the effects of estrogen and LHRHa drugs on bone mineral density.



[Edit - There was a problem with the original link which has now been fixed.  Thanks to Laura for letting us know. ]

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