Propecia and Cancer a good article, kind of ?

[Guest]

Guys,

Read this today on www.cnn.com

Well I guess we press on!!

www.cnn.com/2003/HEALTH/conditions/06/24/prostate.cancer.drug/index.html

[Guest]

Guys,

Read this today on www.cnn.com

Well I guess we press on!!

www.cnn.com/2003/HEALTH/conditions/06/24/prostate.cancer.drug/index.html

[Guest]

The article really says there is a reduction in prostate cancer in those taking finasteride, but in those that got the cancer, it was aggressive.

 

The subjects were in their 60's, I wonder how that effects a guy like me in his 30's?

 

Thanks for the info.

[Guest]

Here is a link to the original online report from the NEJM. This looks like a good study with a large number of participants and random assignment of participants to treatment and placebo groups. While this isn't a full report on the study, for those of us taking finasteride, the results underscore the importance of extra vigilance in prostate cancer screening.

 

Would different effects be found in younger men taking the drug for the same length of time? Good question! An increase in aggressive cancers of 1.3 per hundred over a 7-year-period may not sound like much to some. But, for example, what are the implications for taking this medication beginning at age 20 and continuing until age 49, which would be more than four times the length of exposure? What about starting at age 44, as I did (I'm now 48-years-old)? At age sixty, just old enough to enter this study, I will have been on finasteride for 16 years if I continue with the medication. I don't even want to speculate about what 30 or 40 years of use might mean.

 

There are many unanswered questions about age and duration of treatment as factors. Unfortunately, answering these questions may be much more difficult now. There would be ethical issues in employing a similar research design now that it appears risk of aggressive prostate cancer is increased with long term use. You could study existing long-term users versus non users, but these are not identical comparison groups. The results might point, but never conclusively settle these matters.

 

http://content.nejm.org/cgi/content/abstract/NEJMoa030660v1

[Teddw2ds]

I heard one fascinating theory by Dr. Sanjay Gupta on CNN. He explained that the emergence of more aggressive prostate cancers may simply be the result of suppression of less aggressive cancers. For example, if you rate the aggressiveness of cancer on a scale of 1 to 10, Finasteride may actually be benefiting men by suppressing entirely those cancers of magnitude 1 through 4. This would mean those cancers that do show up are only the more aggressive ones, say magnitude 5 through 10. This is still beneficial, as it prevents cancer in those who would have gotten magnitude 1 - 4 cancers. What we don't know is whether or not the use of Finasteride increased the total incidence of cancers, which would indeed be alarming. Finasteride has been used to control prostate enlargement before it was used for hair loss, so there seemed to be a well established benefit to prostate health.

[HotCreek]

Teddw2ds, beat me to the punch on this one and I think his post is highly relevant. As a simple matter of common sense it is reasonable to infer that maybe finasteride is an effective "barrier" against weak and mild cancers, but just not powerful enough (so to speak) to stop the really aggressive varieties. So, maybe the only cancers that can "get through," and therefore affect finasteride users, are the aggressive ones.

 

In any case, so far as I can see (and I am not a physican) a "cause and effect" relationship has not been clearly demonstrated, (although it is certain that many people will infer that one has.) In other words, just because the finasteride users got aggressive cancers it does not mean that finasteride causes aggressive cancers. Of course, neither is it certain that it doesn't.

 

The good news (if there is any) is that prostate cancer screening is a fairly quick and easy medical test. And physicians recommend that guys over 40 have the test every two or three years. Finasteride users of course, may wish to have it done more regularly and at a younger age.