Medical Forum / Diseases and Disorders / Prostate Cancer / January 2008
Propecia and PCa
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JK - 24 Jan 2008 05:00 GMT I have a 29 year old son that's been taking this hair growth stuff for 2 years with great results but..... why do they have a warning for guys with PCa? Does it increase hormone levels?
 Signature JK Sinrod www.MyConeyIslandMemories.com
tarhoosier@carolina.rr.com - 24 Jan 2008 18:30 GMT > I have a 29 year old son that's been taking this hair growth stuff for 2 > years with great results but..... why do they have a warning for guys with > PCa? Does it increase hormone levels? > > -- > JK Sinrodwww.MyConeyIslandMemories.com JK:
Good question. Propecia is a formulation of a drug called Proscar and this drug has an effect of reducing the amount of dihydrotestosterone in the body. DHT is a metabolite of Testosterone. Without affecting the circulating testosterone, this drug reduces the powerful component DHT and thus counfounds a prostate PSA test. With DHT, a prostate cancer, if present, may grow larger or faster, and by using Propecia, the reduction of DHT my mask a PSA that would otherwise appear suspicious. Many people simply double their PSA scores if they take this drug. ALWAYS, tell your urologist if you are on this drug for any reason, even if it is the over the counter type found in the hair growth compounds.
Alex - 25 Jan 2008 21:33 GMT >> I have a 29 year old son that's been taking this hair growth stuff for >> 2 [quoted text clipped - 15 lines] > reason, even if it is the over the counter type found in the hair > growth compounds. The above information is entirely correct. But one sentence could be misunderstood by a casual reader. It says, "With DHT, a prostate cancer, if present, may grow larger or faster..." I believe that what the poster is saying is that if PCa is present, the Proscar could mask an upturn in PSA. But the sentence could be misconstrued to mean that Proscar could CAUSE the PCa to grow larger or faster. That, of course, is not the case. Yes, Proscar suppresses PSA readings. But no, Proscar does NOT cause any acceleration in cancer growth. (Proscar can also cause a large prostate gland to shrink in size -- mine is now about 40% smaller than before I started taking Proscar about eight months ago.)
Alex
ed@math.uchicago.edu - 25 Jan 2008 22:33 GMT On Jan 25, 3:33 pm, "Alex" <tuchasoffentisch@_NO_SPAM_gmail.com> wrote:
> Proscar could mask an upturn in PSA. > But the sentence could be misconstrued to mean that Proscar could CAUSE the > PCa to grow larger or faster. That, of course, is not the case. Yes, Proscar > suppresses PSA readings. But no, Proscar does NOT cause any acceleration in > cancer growth. > Alex Alex,
Actually, if you check out the results of the PCPT, the men taking Proscar had a higher percentage of high-Gleason score PCa then those not taking it. There have been a number of explanations put forth about thus, ranging from you can't trust the Gleason score to be accurate when using Proscar to DHT being converted to a chemical that slows PCa growth.
My own model predicts that this increase is due to men taking phytoestrogens (such as soy) in conjunction with Proscar. The phytoestrogens generally have anti-cancer effects, but also increase the production of bcl-2, a protein that protects PCa from apoptosis. In general, they are more helpful than harmful. However, Proscar also increases bcl-2 while increasing some apoptotic proteins as well. In general, this is a good thing, however, when you combine Proscar with phytoestrogens, then they are both increasing bcl-2 and you run the risk of raising the bcl-2 level to above a critical threshhold. Dr. Leibowitz has actually observed that his patients taking Proscar had sharp increases in their PSA when taking phytoestrogens, which was reversed when they stopped taking them.
Ed Friedman
I.P. Freely - 25 Jan 2008 23:12 GMT > My own model predicts that this increase is due to men taking > phytoestrogens (such as soy) in conjunction with Proscar. The > phytoestrogens generally have anti-cancer effects, but also increase > the production of bcl-2, a protein that protects PCa from apoptosis. > In general, they are more helpful than harmful. Ed, I consume very little soy in other products, but my favorite Vidalia onion salad dressing is based on soybean oil. I eat something like 80 gms/month of soybean oil in that. Would you advise I cut back on or stop that altogether?
I.P.
ed@math.uchicago.edu - 26 Jan 2008 04:33 GMT > Ed, I consume very little soy in other products, but my favorite Vidalia > onion salad dressing is based on soybean oil. I eat something like 80 > gms/month of soybean oil in that. Would you advise I cut back on or stop > that altogether? > > I.P. I.P.,
I wouldn't worry about taking soybean oil unless your bcl-2 levels are already very high. If you are taking Proscar of Avodart, then you should avoid all soy. Another possible reason to avoid soy would be if you had a Gleason 9 or 10 score. The more aggressive PCa's have slower rates of apoptosis. In many cases, this is due to too much bcl-2, but in some cases due to some other mutation. Since you don't know which is the case, to be safe it would be best to avoid soy for those men.
However, if you don't already have high levels of bcl-2, then the use of soy should be benificial. Numerous studies have demonstrated its anti-cancer properties. The problem for men with PCa is that you don't know how much above or below average your bcl-2 levels are in your cancer cells, and even if you did know, the population is heterogeneous so there most likely will be some cells that thrive on the soy.
To summarize, for all practical purposes, moderate amounts of soy should do little or no harm and may do some good. Massive amounts may kill some more cancer cells, but may spur the growth of others. The only exceptions to this is if you are taking 5AR2 inhibitors or are known to have extremely aggressive PCa cells in you.
Ed Friedman
I.P. Freely - 26 Jan 2008 05:17 GMT > To summarize, for all practical purposes, moderate amounts of soy > should do little or no harm and may do some good. Massive amounts may > kill some more cancer cells, but may spur the growth of others. The > only exceptions to this is if you are taking 5AR2 inhibitors or are > known to have extremely aggressive PCa cells in you. No meds, but my cancer was Gleason 4+4=8 with PSA = 8.8 and PSAV > 2.0 at surgery. SVI, neg margins, N=0, cTNM = 1. Lots of Gleason 4 in several cores, but no 5, as per Bostwick. Quarterly PSA since RP three years ago all at or below 0.030, mostly below 0.015. No drugs anticipated within several years.
Sounds like I may be on the cusp of soy benefit/harm. Your best guess on whether to avoid soy?
I get the impression that unless they assayed my bcl-2 level at the time of my RP pathology, we cannot determine its level. If so, it sounds like I really should let the wife eat the rest of our new case of dressing and find myself a new favorite dressing.
Or -- IhopeIhopeIhope -- my 4+4 and no drugs gives me a pass.
OTOH, my last three PSAs were 0.006, 0.015, and 0.030. Supersensitive noise, we hope, but no guarantees.
I.P.
Steve Kramer - 26 Jan 2008 15:23 GMT "I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
> OTOH, my last three PSAs were 0.006, 0.015, and 0.030. Supersensitive > noise, we hope, but no guarantees. Well, like you've said, I.P., your PSA has been as low as 0.006 twice and in between those two occasions you had PSAs with an almost identical track -- 0.006, 0.012, 0.030 as I recall. It's all under the gold standard (suddenly, I love using that phrase) of 0.10 and would be of no interest if you didn't have the hyper sensitive testing.
 Signature PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 PSAD .056 years Lupron 07/03 (1 mo) 8/03 and every 4 months there after PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years Casodex added daily 07/06 PSA <0.04, <0.05, <0.04, <0.04 10/11/07 Non Illegitimi Carborundum
I.P. Freely - 26 Jan 2008 23:01 GMT > "I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message > [quoted text clipped - 6 lines] > (suddenly, I love using that phrase) of 0.10 and would be of no interest if > you didn't have the hyper sensitive testing. 100% agree. It's what the VA provides, free, whenever I want it, and I'm far more anxious over that TV writers' strike thingie than over my PSA, and I'll hit 0.2 or 1.0 or whatever at the same pace no matter how many decimal places they tack on, so I let 'em have their fun. ;-)
OTOH, anecdotal or not, I'd guess my docs would find it interesting -- maybe not USEFUL, but still interesting -- if this three-decimal stuff actually, clearly, and accurately predicted a textbook biochemical relapse a year in advance.
I suspect if it hits 0.060 next month (quarter) some eyebrows -- including mine -- will go up.
I.P.
Alex - 27 Jan 2008 00:24 GMT > On Jan 25, 3:33 pm, "Alex" <tuchasoffentisch@_NO_SPAM_gmail.com> > wrote: [quoted text clipped - 31 lines] > > Ed Friedman Ed -- Thanks for this information. It's something I was not aware of.
[This kind of analysis is why we pay you the big bucks! (g)]
My doc and I have been talking about me having another biopsy. It will be interesting (!) to see if the Gleason score has changed with Proscar.
Alex
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