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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2008

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Finesteride Study - Promising forPCa Risk Reduction

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Alex - 25 May 2008 00:41 GMT
As a "watchful waiting" guy whose regimen includes taking Proscar
(finesteride), I was interested in the report in Science Daily about the
apparent positive effect of taking finesteride among men not yet diagnosed
with prostate cancer.

See
http://www.fightprostatecancer.org/site/News2?page=NewsArticle&id=9303&JServSess
ionIdr007=cuxkkg5l23.app5a

or http://tinyurl.com/6s7hm8.

Researchers took a second look at a seven-year study of 18,800 men who
received either finesteride or a placebo. In that study, the drug reduced
the risk of prostate cancer by 25%. But initially the data suggested that
finesteride apparently increased the risk that any PCa detected was of
higher risk.

The re-look determined that, because finesteride physically shrinks the
prostate, detection of cancer is more likely -- each biopsy needle took a
larger portion of the prostate gland, and thus was more likely to include
any cancer that did exist. So the shrinkage of the gland caused by the drug
simply made it more likely that any cancer present would be more likely to
be discovered.

The report suggests that taking Proscar or finesteride could reduce the risk
of getting prostate cancer by 25%. Not a bad "side effect" for a drug widely
prescribed as a treatment to prevent hair loss!

The latest study does not include any information about whether taking
finesteride is of any benefit for men who have already been diagnosed with
PCa. My oncologist, who specializes in prostate cancer, believes that
Proscar is beneficial for men with low-PSA, low-Gleason PCa. The theory is
that shrinking the prostate gland also reduces the amount of cancerous
tissue. This is not a mainstream belief.

Alex
Alan Meyer - 26 May 2008 02:42 GMT
> ...
> The latest study does not include any information about whether taking
[quoted text clipped - 5 lines]
>
> Alex

If I remember correctly, Strum uses finasteride (Proscar) or
dutasteride (Avodart) as part of a "triple Androgen Deprivation
Therapy", along with an LHRH agonist like Lupron and a drug
like Casodex.  If it is successful in bringing PSA to near
undetectable levels, the Proscar or Avodart may be used alone
for some period of time to give the patient relief from the
effects of the other drugs.

So I don't know if what your suggesting is fully "mainstream",
but I don't think it's far off the beaten path.

One thing to watch out for is that these drugs lower the PSA
quite a bit.  Some say 50%.  So when you watch your PSA
as part of watchful waiting, you have to take that into account.

I'm no doctor, but I should think that if the strategy you are
following is working, it's going to be easier on you than
surgery or radiation.  But be sure to emphasize the watchful
part and not just the waiting part.  If things start to go south,
you want to do something while it's still easy to treat.

Best of luck.

   Alan
Alex - 27 May 2008 02:09 GMT
>> ...
>> The latest study does not include any information about whether taking
[quoted text clipped - 30 lines]
>
>    Alan

Alan, thanks for the cautionary advice. I am indeed watching the PCa
carefully. I see an oncologist 4 times a year and get color doppler
ultrasounds twice a year. I am fully prepared to grab a taxi to the nearest
DaVinci machine if the cancer starts acting up. (I'm not a good candidate
for radiation.) But for the moment, the cancer seems to be content to remain
indolent.

I was diagnosed with a PSA of 6.2 and a Gleason of 6 (3+3) almost exactly
three years ago. Since then the PSA actually trended down, even before I
started taking Proscar, into the range of 4.5 to 3.3. Of course since
starting Proscar it has dropped further. Last test was two months ago, with
PSA at 1.5.

My onc favors Proscar over Avodart because he thinks it has fewer side
effect, even though those for Avodart usually are mild. (A small risk of
gynocomasty, or enlarging of the breast, in about one man out of 14 --  
easily prevented with one treatment with radiation across the chest.) And
because Proscar/finesteride is available as a generic, it is much cheaper
than Avodart. I pay $10 a month at Costco, which is probably less than I
spend on the mouthful of supplements I gag down daily.

Alex
Alan Meyer - 27 May 2008 22:07 GMT
> ...
> Alan, thanks for the cautionary advice. I am indeed watching the PCa
[quoted text clipped - 3 lines]
> candidate for radiation.) But for the moment, the cancer seems to be
> content to remain indolent.

Sounds like you're on top of it.

> I was diagnosed with a PSA of 6.2 and a Gleason of 6 (3+3) almost exactly
> three years ago. Since then the PSA actually trended down, even before I
> started taking Proscar, into the range of 4.5 to 3.3. Of course since
> starting Proscar it has dropped further. Last test was two months ago,
> with PSA at 1.5.

Excellent!

> My onc favors Proscar over Avodart because he thinks it has fewer side
> effect, even though those for Avodart usually are mild. (A small risk of
[quoted text clipped - 3 lines]
> than Avodart. I pay $10 a month at Costco, which is probably less than I
> spend on the mouthful of supplements I gag down daily.

I saw a web page recently comparing the two drugs:
http://www.anagen.net/glaxo7.htm

It doesn't say who paid for the study, but I suspect it was the makers of
Avodart - since they (Glaxo Smith Kline) are most often quoted in the
references.  The study claimed some small differences in the two products,
but I'm not at all sure they were significant and, if Glaxo paid for the
study, I'm not even sure they were real.

   Alan
 
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