proscar / finasteride / propecia - reduce rate of PCA by 25%

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tatt2man
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Date Joined Jan 2010
Total Posts : 2845
   Posted 8/15/2010 6:24 PM (GMT -6)   
interesting article regarding drug used for one thing possibly benefiting /harming something else... Proscar / Finasteride / Propecia used to treat BPH as well as male pattern baldness... supposedly reduces the rate of PCa by 25%....

http://www.medicinenet.com/script/main/art.asp?articlekey=118871

post correction - the link doesn't work so do a cut and paste - that works -
Age: 54 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB - hooorah!
Next PSA: October 8, 2010 -TBA

Post Edited (tatt2man) : 8/15/2010 7:54:49 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/15/2010 8:35 PM (GMT -6)   
couldn't get this link to work, tried several times
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39

Fairwind
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Date Joined Jul 2010
Total Posts : 3891
   Posted 8/15/2010 8:39 PM (GMT -6)   
The downside is, if you are taking Proscar (finesteride) and you ARE diagnosed, you are far more likely to have a high Gleason score cancer...While they have gone back and "after taking a second look, that might not be the case" I don't see sales of Proscar taking off anytime soon...These drug pushers are relentless in their efforts to protect a billion dollar a year drug..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

Post Edited (Fairwind) : 8/15/2010 8:36:01 PM (GMT-6)


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 8/15/2010 8:56 PM (GMT -6)   
http://www.medicinenet.com/script/main/art.asp?articlekey=118871

post correction - the link doesn't work so do a cut and paste - that works -
Age: 54 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB - hooorah!
Next PSA: October 8, 2010 -TBA

Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 8/15/2010 9:51 PM (GMT -6)   
I emailed Catalona about this a while ago (if this is the same study), his opinion was these drugs can end up just masking the cancer.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/15/2010 10:15 PM (GMT -6)   
thanks bronson, will try that, just wanted to read it too
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3891
   Posted 8/15/2010 10:31 PM (GMT -6)   
Squirm said...
I emailed Catalona about this a while ago (if this is the same study), his opinion was these drugs can end up just masking the cancer.


That's exactly what happened to me..My prostate was slightly enlarged but I had no urinary symptoms. After the second clean biopsy, my U-doc said lets try Proscar and see if it brings the PSA down..I said "but I don't have any symptoms".. He replied, that's right, and you don't want any either (speaking of BPH)..We were both delighted when my PSA was cut in half. Little did we know..But when a DRE showed my prostate had shrunk but my PSA had started up again, he insisted on a third biopsy which returned a Gleason 9...Hindsight is always 20-20...
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

Postop
Regular Member


Date Joined Feb 2010
Total Posts : 385
   Posted 8/15/2010 10:41 PM (GMT -6)   
Here is the link to the abstract of the article that is discussed:

http://www.ncbi.nlm.nih.gov/pubmed/20699373

This is just an article on prescribing habits of physicians for finasteride. There isn't any new information in this article to shed light on whether they should.

When I was thinking about whether I should take this, my concern was that reducing the percentage of men with lower grade PCa in biopsies done over 2 or 3 years, doesn't tell you that it reduces the chance of developing higher grade PCa and getting sick over 10 or 20 years. There seem to be different spins in different articles as to whether there was a slight trend for increased high grade PCa or not, but no one seems to say that there is evidence that it reduces high grade PCa. I wasn't too keen on the breast enlargement side effect, either. If there was convincing evidence that finasteride actually saved lives, however, I'd take it over surgery, any day.

There are articles in the press that make it seem like this is proven cancer prevention that pigheaded doctors are ignoring, but like Squirm said, the urologist I talked to wasn't convinced that it did anything to prevent the appearance of bad PCa. It seems like everything to do with PCa needs a longer study to know what's really going on. Probably there will be a day when you can actually take some kind of pill to prevent PCa, and people will look back at prostate surgery as barbaric. Actually, most of us who've had it probably look back and already think it's barbaric, just necessary barbarism.

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 8/16/2010 10:39 AM (GMT -6)   
I have spent a substantial (wife would say "inordinate") amount of time trying to determine whether to take finasteride or dutasteride to reduce my chances of getting prostate cancer. (If I were going to take either, it would be dutasteride). I have read dozens of articles on this subject, and have discussed it with several very well regarded prostate cancer experts. And, still, it is nearly impossible to determine what to do. The opinions I have received, from expert doctors, have ranged from "you are nuts if you don't take this" to "it is dangerous to take it." I even received different recommendations from two urologists at the same leading academic medical center. So, it is just one of those questions to which there is -- at least at this point -- no right answer. I will say this: it appears (to me) that the REDUCE study results negate the notion that 5-alpha-reductase inhibitors cause high-grade tumors. Those who favor use of these drugs for chemoprevention suggest that the reason for more high grade tumors in the PCPT study (the first of the two studies) was that finasteride shrinks the prostate and therefore makes detection of high grade tumors easier. Those who oppose argue (among other things) that by decreasing PSA, it gives patients a false sense of security, perhaps resulting in a decision not to get a biopsy (until it is too late...). There is also the issue of what was found during "for cause" biopsies and what was found during "end of study" biopsies because -- unlike in the real world -- in these studies everyone was biopsied.

There are lot of other arguments in favor or against this -- and I could write pages about it -- but I won't.
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 8/16/2010 10:44 AM (GMT -6)   
Some might be interested in this recent blog post:

http://www.pharmastrategyblog.com/2010/08/chemoprevention-in-prostate-cancer-do-5alpha-reductase-inhibitors-make-things-worse.html
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/16/2010 4:43 PM (GMT -6)   
Leibowitz uses proscar in ADT3 in the off cycle after 13 months, quit ADT3 and stay on proscar.  Seems to have worked pretty well in his patients and in Rick K, Michigan guy at year 15 without any other treatments yet.  It will mask ones normal psa level by maybe 50% we have heard. It blocks dihydra T levels is the theory for controlling PCa and psa levels.  I am only the messenger, I don't know for fact or can prove anything on this.
Rick K just had  biopsies done and no cancer found, this is the 3 rd time since original off treatments(over numbers of years now) and biopsies found clear.  (no warranties on biopsies either way neg. or pos.)   Interesting anyway.
Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 8/16/2010 3:55:34 PM (GMT-6)

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