Estramustine phosphate (EMP), also known as estradiol normustine phosphate and sold under the brand names Emcyt and Estracyt, is a dual estrogen and chemotherapy medication which is used in the treatment of prostate cancer in men. It is taken multiple times a day by mouth or by injection into a vein.Side effects of EMP include nausea, vomiting, gynecomastia, feminization, demasculinization, sexual dysfunction, blood clots, and cardiovascular complications. EMP is a dual cytostatic and hence chemotherapeutic agent and a hormonal anticancer agent of the estrogen type. It is a prodrug of estramustine and estromustine in terms of its cytostatic effects and a prodrug of estradiol in relation to its estrogenic effects. EMP has strong estrogenic effects at typical clinical dosages, and consequently has marked antigonadotropic and functional antiandrogenic effects.EMP was introduced for medical use in the early 1970s. It is available in the United States, Canada, the United Kingdom, other European countries, and elsewhere in the world. Medical uses
EMP is indicated, in the United States, for the palliative treatment of metastatic and/or progressive prostate cancer, whereas in the United Kingdom it is indicated for the treatment of unresponsive or relapsing prostate cancer. The medication is usually reserved for use in hormone-refractory cases of prostate cancer, although it has been used as a first-line monotherapy as well. Response rates with EMP in prostate cancer are said to be equivalent to conventional high-dose estrogen therapy.Due to its relatively severe side effects and toxicity, EMP has rarely been used in the treatment of prostate cancer.
Rarely, X-ray may show lateral joint space widening, squaring of the lateral condyle, cupping of the lateral tibial plateau and hypoplasia of the lateral tibial spine that suggest discoid meniscus. Treatment/Management
In a patient complaining of acute onset knee pain, an X-ray study would be done to rule out any bony pathology such as a fracture. Since it is difficult to diagnose meniscal anomalies with X-ray, an MRI would be necessary to visualize the discoid meniscus. If the patient is asymptomatic and does not complain of significant locking sensation in the knee or pain, treatment is conservative and consists of stretching and strengthening exercises for the quadriceps and hamstring muscles. “In cases where there is significant disability, surgical excision may be needed. When the discoid meniscus is severely damaged, total excision of the meniscus may be necessary. In most cases where the meniscus is still generally intact, a partial excision to preserve the cushioning function may be sufficient.”

See also
Knee pain
Knee osteoarthritis
Meniscal cyst

References
External links
Discoid Meniscus in eMedicine