Finasteride

[AMT4566]

What are the latest findings on the effects of Finasteride on prostate cancer? Thank you in advance

[Tall_Allen]

Finasteride may be used for several purposes. There is nothing in your profile. Why are you taking it?

[AMT4566 in reply to Tall_Allen]

thank you very much for your reply. I’m currently under active surveillance, GS 6 since few months ago. I’m not taking it currently. I

A friend mentioned it working for migraine headaches, something I suffer frequently from. I was thinking of taking it for that purpose, however came across some study showing it may have negative impact on more aggressive PCs. That’s why I thought I would ask info here and if anyone knows about the latest findings. I would appreciate any insights. Thank you again in advance

[Tall_Allen in reply to AMT4566]

IMO, it is a very good idea oncologically for men on active surveillance. See Section I on 5ARis:

prostatecancer.news/2022/06...

(there are links to studies refuting the negative impact on more aggressive PCa)

About 20% of men get ED from those drugs, so you have to decide if the risk is one you want to take. Consider taking with daily Cialis.

[AMT4566 in reply to Tall_Allen]

Thank you so very much again for your responses. This was very helpful

[zeddy54]

Hi. Just a warning that finasteride can suppress the PSA level, and thereby can result in an apparently lower PSA result, whereas prostate cancer can be progressing albeit undetected. This happened with my father in law, but we were not aware of this scenario, and his Urologist was likewise either ignorant or uncaring. My father in law consequently died OF (not with) metastatic prostate cancer with an artificially suppressed PSA level of 7.5 due to being on finasteride, until the later few months when PSA rose but far too late for any effective treatment options.

These days, with MpMRI scans, etc available, then hopefully such a scenario would be avoided.

[AMT4566 in reply to zeddy54]

Thanks very much. You raise a good point.

[janebob99]

I've done a lot of research about Dutasteride (2nd generation Finesteride) and have about 15 papers about it. If you send me a private message with your email address, I will email you a few of the most relevant papers.

Case in point. My own PSA was rising quickly from 5 to 10 over 8 months. I had a MRI that discovered a 1.3 cm long tumor (PIRADS 5).

At the same time my DHT was measured as High. Then, I read that DHT is 10 times more potent than testerosterone. A light went off in my head, and I started taking Dutasteride monotherapy to reduce my DHT. On just Dutasteride (No ADT, No RT or RP), my PSA dropped from 10 to 2.4 over 5 months. See my attached PSA history.

Now, it's important to know that 25-30% of men don't respond to Dutasteride. This could be why it's not prescribed more often. The only way to tell if you are a good responder is to try the medication for 3-4 months, and see if your PSA drops by about 50% (which is typical).

I will send you information on the "negative impact on more aggressive PCs", which has been thoughly debunked by subsequent analyses in multiple papers.

The gold standard for any drug treatment is if the tumor shrinks. This has been studied.

They did a randomized, double-blind trial men with PCa, compraring Dutasteride to Placebo. They used a MRI machine to measure the tumor size, and found that after only 6 months that men taking Dutasteride had their tumors shrink by an average of 31%, compared to men on placebo whose tumors grew 17%. This result demonstrates that Dutasteride is an effective drug to significantly shrink tumor size.

Three other studies on N=4000, 4500, and 8000 men have found that Dutasteride monotherapy reduces PCa by an average of 40% (range is 23 - 51% reduction), with no increased risk of high-grade cancers (Gleason scores 8-10).

There is no evidence that Dutasteride is a "cure". But, rather, it delays progression and buys you time so that you can learn about all of your treatment options, and make an informed decision what to do next. It's relatively inexpensive, and has a good safety profile.

Bob

PSA history

[AMT4566 in reply to janebob99]

Thank you very much for your response. DM sent per your suggestion.