To my surprise my urologist readily prescribed Prazosin to replace Tamsulosin, after reading the retrospective study that Bruce SF supplied me with and I forwarded to my Doc with my request to change drugs.
As a trader I always look at risk and reward, this one seems to be a no-brainer, very little risk and plenty of potential upside, unless I have a reaction to the drug itself.
Purple Bike wrote an excellent post that summarizes my thinking. I hope that in 10 years I can report that My PSA and scans show no progression.
Thanks Bruce SF for the idea. set my mind racing as well.
4 days ago
I would suggest that the retrospective study, showing benefits for prazosin user patients, has a better chance than the average retrospective study of the drug in question to actually be beneficial.
Users of prazosin have a worse cancer status than controls, otherwise they have no apparent dissimilarities..Selection bias could clearly play a role as is so often the case with retrospective studies. Users of P might have more healthy behavior, better health insurance and so on than the PCa patients not on BP medication. But the users of the second BP medication, tamsulosin, did in most respects not have an improved outcome compared to controls, and had a greatly inferior outcome compared to prazosin. Why is this? Of couse there can be confounders, but at the least, it is not obvious that users of tamsulosin have worse health behavior etc than users of prazosin. P and T are similar drugs, both being α1-adrenoceptor antagonists
Then there are the preclinical studies, maybe of limited use on their own, but buttressing what clinical data there is. From the study referenced by Scout4answers: “There is substantial evidence that the quinazoline α1 antagonists (terazosin, prazosin and doxazosin) display cytotoxicity in prostate cancer cell lines, effects that are not observed with the sulphonamide derivative tamsulosin. ........ In vivo studies in mice have shown that these effects also occur at clinically relevant doses, with reduction in tumour growth, metastasis and decreased angiogenesis observed in models of prostate cancer”
So lab and animal studies show protective effects from prazosin but not from tamsulosin. The retrospective study on men likewise showed a greatly superior effect of P compared to T and controls.
This is of course very far from any proof of efficacy of P for PCa, which will need a RCT phase 3 years ahead in the future if there ever is one. But the combination of lab/animal data and retrospective study pointing in the same direction to me indicates that it could be worthwhile considering prazosin, if side effects are tolerable and in particular if one has an interest in lowering blood pressure. This post set my mind racing.
Swing dancing with Coco at pier 290 in Lake Geneva last weekend to celebrate # 74.
10 more years of this would be a fine outcome.