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Polyestradiol phosphate (PEP), sold under the brand name Estradurin, is an estrogen medication which is used primarily in the treatment of prostate cancer in men. [1] [9] [2] [10] It is also used in women to treat breast cancer, as a component of hormone therapy to treat low estrogen levels and menopausal symptoms, and as a component of feminizing hormone therapy for transgender women.
Response rates with EMP in prostate cancer are said to be equivalent to conventional high-dose estrogen therapy. [18] Due to its relatively severe side effects and toxicity, EMP has rarely been used in the treatment of prostate cancer. [4] This is especially true in Western countries today. [4]
Estradiol undecylate has been used as a form of high-dose estrogen therapy to treat prostate cancer, but has since largely been superseded for this indication by newer agents with fewer adverse effects (e.g., gynecomastia and cardiovascular complications) like GnRH analogues and nonsteroidal antiandrogens.
The use of high-dose estrogen therapy in breast cancer has mostly been superseded by antiestrogen therapy due to the improved safety profile of the latter. [17] High-dose estrogen therapy was the standard of care for the palliative treatment of breast cancer in women up to the late 1970s or early 1980s. [18
The main drawback of modern HDE for prostate cancer is a high incidence of gynecomastia of about 40 to 77%, although it is generally only mildly or modestly discomforting. [54] In addition, prophylactic irradiation of the breasts can be used to prevent it and has minimal side effects, mostly consisting of temporary skin discoloration. [54]
The risk of dying from prostate cancer or having acute bladder side effects may be similar to that of longer radiation treatment. [28] Others use a "triple modality" combination of external beam radiation therapy, brachytherapy, and hormonal therapy.
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