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`Estramustine
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`Chemocare.com
`
`Care During Chemotherapy and Beyond
`
`Estramustine
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`(estraMUSteen)
`®
`Trade names: Emcyt
`Chemocare.com uses generic drug names in all descriptions of drugs. Emcyt is the trade name for estramustine. In some cases, health care
`professionals may use the trade name emcyt when referring to the generic drug name estramustine.
`Drug type: Estramustine is a combination anticancer ("antineoplastic" or "cytotoxic") chemotherapy drug classified as an "antimicrotubule agent," and
`it also has hormonal therapy features. (For more detail, see "How this drug works" section below).
`What Estramustine Is Used For:
`Estramustine is used to treat prostate cancer that has progressed or spread.
`Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
`How Estramustine Is Given:
`Estramustine is given in pill form (a capsule), taken by mouth.
`Estramustine should be taken with water 1 hour before meals or 2 hours after meals to prevent stomach upset.
`The amount of estramustine that you will receive depends on many factors, including your height and weight, your general health or other health
`problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.
`Side Effects:
`Important things to remember about the side effects of estramustine:
`
`Most people do not experience all of the side effects listed.
`Side effects are often predictable in terms of their onset and duration.
`Side effects are almost always reversible and will go away after treatment is complete.
`There are many options to help minimize or prevent side effects.
`There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
`The following side effects are common (occurring in greater than 30%) for patients taking estramustine:
`Breast tenderness
`Breast enlargement (mild) (see sexuality)
`Decrease in libido and impotence (see sexuality)
`Increases in blood tests measuring liver function (Lactate Dehydrogenase and AST). These return to normal once treatment is discontinued. (see
`liver problems).
`These side effects are less common side effects (occurring in about 1029%) of patients receiving estramustine:
`Edema (swelling of face, feet or hands)
`Shortness of breath (see lung problems)
`Nausea
`Diarrhea
`
`Your fertility, meaning your ability to conceive or father a child, may be affected by cisplatin. Please discuss this issue with your health care provider.
`
`Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform
`your health care provider if you experience any unusual symptoms.
`When to contact your doctor or health care provider:
`Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
`Shortness of breath, difficulty breathing
`The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing
`any of the following:
`Nausea (interferes with ability to eat and unrelieved with prescribed medication)
`Vomiting (vomiting more than 45 times in a 24 hour period)
`Diarrhea (46 episodes in a 24hour period)
`Swelling, redness and/or pain in one leg or arm and not the other
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`Swelling of the feet or ankles. Sudden weight gain
`
`Always inform your health care provider if you experience any unusual symptoms.
`Precautions:
`Before starting estramustine treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over
`thecounter, vitamins, herbal remedies, etc).
`Milk, milk products, and calciumrich foods (including calcium containing antiacids) or drugs may interfere with the absorption of estramustine.
`These products should not be taken at the same time as estramustine.
`Estramustine may be inadvisable if you have had a hypersensitivity (allergic) reaction to nitrogen mustard, estradiol or estramustine.
`Estramustine is not recommended for people who have problems with blood clots.
`Do not receive any kind of immunization or vaccination without your doctor's approval while taking estramustine.
`Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in
`pregnancy only when benefit to the mother outweighs risk to the fetus).
`For both men and women: Do not conceive a child (get pregnant) while taking estramustine. Barrier methods of contraception, such as condoms,
`are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
`Do not breast feed while taking this medication.
`SelfCare Tips:
`Estramustine should be stored in the refrigerator.
`Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
`This medication causes little nausea. But if you should experience nausea, take antinausea medications as prescribed by your doctor, and eat
`small frequent meals. Sucking on lozenges and chewing gum may also help.
`In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
`Get plenty of rest.
`Maintain good nutrition.
`If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer
`other suggestions that are effective in managing such problems.
`Monitoring and Testing:
`You will be checked regularly by your health care professional while you are taking estramustine, to monitor side effects and check your response to
`therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will
`also be ordered by your doctor.
`How Estramustine Works:
`Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come
`into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks
`and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The
`cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
`
`The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells
`the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy
`will kill the cells, causing the tumor to shrink. They also induce cell suicide (selfdeath or apoptosis).
`
`Chemotherapy drugs that affect cells only when they are dividing are called cellcycle specific. Chemotherapy drugs that affect cells when they are at
`rest are called cellcycle nonspecific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which
`a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
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`Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the
`cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most
`commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts,
`mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
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`Chemotherapy (antineoplastic drugs) is divided into five classes based on how they work to kill cancer. Although these drugs are divided into groups,
`there is some overlap among some of the specific drugs.
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`Estramustine is an antimicrotubule agent. It is cell cycle specific. It acts on the microtubule structure and function of the cell by attaching to the
`microtubuleassociated proteins. Antimicrotubule agents are also signal transduction inhibitors and are sometimes referred to as targeted therapy.
`
`Estramustine is made up of a combination of the antineoplastic substance nornitrogen mustard and the estrogen derivative estradiol phosphate.
`This design was to target cancer cells with estrogen receptors on their surface. However, it was found to be active against estrogen receptornegative
`tumor cells as well.
`Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information
`contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.
`
`Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information
`about the 4th Angel Mentoring Program visit www.4thangel.org
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