proscar and avodart

I know that these drugs are not part of NCCN guidelines, but since everyone holds that DHT is more activating of the (structure known as the) androgen receptor than is testosterone itself, I dont see why the doctors are so reulctuant to prescribe it. They say, I think, that if you get metastatic PC, it will be more aggressive, but the question should be one of overall survival. No?

[gusgold]

that was found not to be true...Dr. Myers was a huge believer..said Avodart kept 50% of his patients off a 2nd cycle of ADT

[Hidden in reply to gusgold]

I am aware of Dr Meyers of course. what about NCCN guidelines, and who says its now true, and how did they find out?

Does Dr Meyers use only 1 (3 month?) depot of ADT with ongoing Avodart?? I had not heard that.

[Sisira]

It was from Dr.Myers only that I learned the importance of using Avodart ( Dutasteride). Both Dutasteride ( Avodart ) and Finasteride ( Proscar ) are 5AR Inhibitors which suppress the conversion of T to DHT which is said to be about 10 times more potent than normal T and thus can fuel the growth of PCa markedly. To be specific what he says is when he brings a patient to remission by hormone therapy and stop the ADT, during the off period he administers Avodart and majority of the patients will remain in stable remission for many years. Avodart is said to be better than Proscar. Presently I am also taking Avodart - one capsule a day. I think this can be effective obviously during the period when the cancer cells are hormone sensitive.

However, I have not seen any other medical oncologist or urologist adding such indications to Avodart/Proscar in the treatment of PCa.

Sisira

[herb1 in reply to Sisira]

I want to agree; my oncologist makes small potatoes of Avodart, doesn't think it does anything once prostate cancer is there; in other words it may reduce psa but once that's done, it's value is over. I want to not agree.

Now, just to confuse the issue: Avodart has a long half life, so it should stay in your system for several days. I've cut my intake to every other day; I still feel that should still produce a steady-state concentration in my blood. Any comments.

herb

[Hidden in reply to herb1]

So your doctor thinks that Avodart is useful for BPH, but that is all. So that means that he thinks that there is no overlap between prostate cancer biology and BPH biology. Do you also agree that they are (completely) separate disorders? [Specifically, is BPH caused by an over growth of prostate cells? If so, how can one be confident that they are completely separate?]

[herb1 in reply to Hidden]

Mart: to tell the truth I've never looked at the bph/pca as related on not. I can't think of any study of that. Do you have such? Remember, just because two things occur in the same cohort does not mean they are related. Both of these seem to hit older men, but does that mean anything?

herb

[Hidden in reply to herb1]

No I have not seen a study that demonstrates any interesting commonality between BPH and prostate cancer, and I think I remember statements that say they are different. I just don't trust most articles I read if the conclusions seem weird to me. But since they are both diseases regarding unusual growth of the prostate, I don't see how you can exclude, in the beginning, there being some commonality of mechanism at some level. But I have not read much about BPH at all. The fact that BPH is treated with an anti-DHT drug indicates that almost certainly testosterone and the Androgen Receptor are involved. So there is a commonality right off the bat.

[Sisira in reply to herb1]

herb, You have a valid point on the basis of long half life ( I don't know the exact duration ).

Your comment is much appreciated.

Sisira

[herb1 in reply to Sisira]

Sisira: I want to make it clear to you and all others that my alternate day use of avodart is not "approved" by any of my docs, I simply haven't told them! I will admit that I usually up avodart to daily about a month before a psa test, so I'm 2-3 months off, 1 mo on daily use.

Herb

[Hidden in reply to Sisira]

What counts as remission? Undetectable PSA?

[Sisira in reply to Hidden]

Exactly martin. Undetectable PSA and also no PCa related symptoms.

Hope you are doing well.

Sisira