Proscar vs. Propecia

[Frankenski]

Both of these drugs are Finasteride. 1mg. for male pattern baldness, and 5mg. for PCa.

Assuming you're a healthy man, can the Propecia, 1mg., affect your PSA enough to lower it to almost nil numbers?

F

[pjoshea13]

There is an old (1992) study that compared the two doses on men with BPH:

"During the first six months, the median size of the prostate decreased progressively in both finasteride-treated groups after which it did not change significantly, and it was significantly smaller in both finasteride-treated groups than in the placebo group at all times ... After 12 months of treatment, the prostate had shrunk by 19 percent from base line in the group given 5 mg of finasteride, by 18 percent in the group given 1 mg of finasteride, and by 3 percent in the group given placebo".

No mention of PSA, but, clearly, 1mg does have a significant effect.

& of course, both doses would have PCa screening implications.

nejm.org/doi/full/10.1056/N...

In a later (2007) study that did look at PSA:

"Within 48 weeks of randomisation, men aged 40-49 years and 50-60 years who were assigned 1 mg/day finasteride had a median decrease in serum PSA concentration of 40% ... and 50% .., respectively. In men assigned placebo, the median changes were 0% ... and a median increase of 13% .., respectively."

ncbi.nlm.nih.gov/pubmed/171...

The men in the latter study presumably did not have suspected BPH (or PCa).

-Patrick

[Frankenski in reply to pjoshea13]

Thank You Patrick.

[Hidden in reply to pjoshea13]

Interesting. I wonder if low dose finisteride would offer some benefit to PC patients who are still showing low PSA readings after treatment. Sort of like of statin use as general goodness preventative measure?

[pjoshea13 in reply to Hidden]

Dr. Myers found that some men on ADT needed a 5alpha-reductase inhibitor [5ARI] to inhibit dihydrotestosterone [DHT]. He preferred Dutasteride [Avodart] to Finasteride.

The vlog where he discussed this was made before Avodart became generic. He spoke of monitoring DHT to find the minimum dose that would do the job. Cost is less of an issue these days, but why use more than you need? Some patients needed only one dose per week.

Myers said that it wasn't testosterone [T] that we should worry about while on ADT, but the far more potent DHT. Normally, our DHT is made only by the action of 5AR on T, but some men also produce DHT via another pathway. In fact, ADT sometimes selects for PCa cells that find that pathway.

Myers himself was a copious producer of DHT, so he was sensitive to the problem. He thought it crazy that doctors in the field would ignore DHT.

My concern is that DHT conversion happens privately within PCa cells. It's an intracrine process, so why would DHT be measurable in blood? I think it prudent to take Avodart anyway.

& I think that it's a good idea to use it while on an ADT vacation. T levels do not recover quickly, so this could be another low-dose scenario.

-Patrick