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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2005

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link between Prostate Cancer and Finasteride... please help

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PWalker - 23 Jan 2005 08:21 GMT
Hi,

I posted recently about my father (73 yrs old) recently diagnosed with
prostate cancer.

As a result of this news I decided to get a blood test myself. I am 35 yrs
old. My current PSA is 0.84. That sounds ok since I have been told the upper
limit (before i should start worying) is around 1.4

But its not really ok since I have been taking finasteride for around 5
years (in the form of proscar to stop my hair from falling out). Given the
fact that taking finasteride decreases your PSA by around 50%
http://www.bchealthguide.org/kbase/topic/detail/drug/aa140863/detail.htm
that would mean my PSA should be around 1.68 if i wasnt taking Finasteride.
Should i be concerned, as this is above the 1.4 upper limit? The above
webpage says the upper limit is 2.0. So is the upper limit 1.4 or 2.0?

Are there any articles, info about the relationship between PSA &
Finasteride? There was a recent article about this:

Finasteride (Propecia) and the Promotion of High-grade Prostate Cancer
W Reid Pitts Jr; Archives of Dermatology; Jul 2004; 140, 7; AMA Titles; pg.
885

In the article it was said that:  It was found that "Finasteride prevents or
delays the appearance of prostate cancer" by 24.6% (finasteride, 803/4368
[18.4%]; placebo, 1147/4692 [24.4%]) but "increased the risk of high-grade
prostate cancer (Grade 7, 8, 9, 10)" by 67% (finasteride, 280/757 [37%];
placebo, 237/1068 [22.2%] [P<.001]) in men diagnosed as having prostate
cancer.3

What can i do to possibly prevent the onset of prostate cancer? Any natural
herbs/homeopathy/naturopathy etc?

Any help most appreciated!

Cheers,
Peter
James A. Honeychuck - 23 Jan 2005 08:51 GMT
Based on my reading, conventional medicine offers no definitive advice
about preventing prostate cancer.  Diet would appear to be a
contributing factor, but no one has nailed down exactly how it works.
Conventional medicine would probably just suggest a healthy diet and
lifestyle.

Don't know anything useful about alternative medicine.  Since it doesn't
follow the scientific theory, it's hard to evaluate.  My only caution is
that if you are taking any herbs or potions, be sure to tell your
conventional doctor.

With PSA readings as low as 1.4 or 2, doctors probably don't pay any
attention to the actual number, they just watch for any rise (PSA velocity).

Sounds like you'd better quit that finasteride.

jimhoney

> Hi,
>
[quoted text clipped - 34 lines]
> Cheers,
> Peter
Steve Kramer - 23 Jan 2005 13:02 GMT
I have good news for you, Peter.  No one currently on this NG, or who has
been on this NG in the last three years, was dx'd with PCa before the age of
39.  Only two were dx'd before the age of 42.  The youngest I ever saw in
back posts was 36.

However, 35 is a good time to start getting your PSA tested.  That way you
can have a baseline in case your PSA starts to climb.  And THAT is the real
indicator.  If you are at .84 for five years, then go to 1.2, then to 2.5,
you may have PCa.

Finally, if you're 35 and you are not a news anchor, quit worrying about
your damned hair!

Signature

Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3bN0M0
PSA  .1  .1  .1  .27  .37  .75
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Lupron (1 mo) 07/21/2003 @ 48
PSA  .07 .05 .06
Lupron (4 mo) 8/03 (48), 12/03, 4/04 (49), 09/04 (50)
non Illegitimi carborundum

> Hi,
>
[quoted text clipped - 34 lines]
> Cheers,
> Peter
ron - 23 Jan 2005 17:37 GMT
Hi Peter..."Ditto" to Steve's point on tracking your PSA over time, the
trend is the key.  As to the study you reference, PubMed does show an
abstract, so I cant' be certain, but I suspect it is based on the paper
on this subject from 2003 ("The influence of finasteride on the
development of prostate cancer", Thompson IM, Goodman PJ, Tangen CM,
Lucia MS, Miller GJ, Ford LG, Lieber MM, Cespedes RD, Atkins JN,
Lippman SM, Carlin SM, Ryan A, Szczepanek CM, Crowley JJ, Coltman CA
Jr., N Engl J Med. 2003 Jul 17;349(3):215-24).  Finasteride is used for
hair regrowth,and is also widely used in hormonal therapy treatment of
prostate cancer (PCa).  The good news from the study was that
finasteride appears to significantly reduce or delay the occurrence of
PCa in the general population.  The disturbing sidebar, that when PCa
does occur after finasteride use, it is more aggressive, has been
called into question by several noted pathologists.  They point out
that any hormonal treatment will alter the appearance of PCa cells and
make Gleason grading more difficult, if not impossible.

As to your question on PCa prevention, things that are part of a
heart-healthy lifestyle (healthy eating, exercise, molecularly
distilled omega-3s with a high DHA/EPA ratio, etc.) also appear to be
good for cancer prevention.  For PCa specifically, selenium and vitamin
E, particularly the gamma isomer, are probably the most generally
agreed upon supplements that appear to have some value...Best wishes
and good health, Ron

P.S.  Having mentioned PubMed, here is a link:

http://www.ncbi.nih.gov/entrez/query.fcgi

It is an amazing tool and it covers all medical areas, not just PCa.
Type in search terms and it searches through all the journals it
abstracts and shows you the hits, usually with links to the abstracts.
Leonard Evens - 23 Jan 2005 18:28 GMT
> Hi Peter..."Ditto" to Steve's point on tracking your PSA over time, the
> trend is the key.  As to the study you reference, PubMed does show an
[quoted text clipped - 28 lines]
> Type in search terms and it searches through all the journals it
> abstracts and shows you the hits, usually with links to the abstracts.

I strongly endorse what ron has said.   I would only add that since your
father's cancer was diagnosed at age 73, you are not technically
supposed to be at higher risk for prostate cancer than men in the
general population.   That wwould be the case if your father or other
close male relative had been diagnosed at a somewhat younger age, say
before age 65.

You should check with your doctor.  Because of your father, it might be
helpful to have a baseline measurement earlier as some have suggested.
But is is possible your doctor will think you can wait until you are
older before having regular PSA tests.  For men not at special risk,
that would be age 50.  I believe that PSA testing for men in their 30s
is at this point in time somewhat controversial.

I agree with Steve that you should stop owrrying about your hair, but
then again I've been bald since I was 20.  ;-)
Stephen Jordan - 23 Jan 2005 20:27 GMT
On January 23, Leonard Evens wrote, in pertinent part:
>  
> I agree with Steve that you should stop owrrying about your hair, but
> then again I've been bald since I was 20.  ;-)

OTOH, before going all to pieces over this, be aware that the
finasteride dosage of Propecia (for hair) is just one mg qd. The dosage
of Proscar for BPH and PCa usages is five times that: five mg qd.

As usual, do not think that medical info from us is authoritative.
Before taking any action, check with the medics.

Regards,

Steve J
 
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