Re: Re: Your opinion

[Guest guest]

It is obvious that existing cancers are not reduced or suppressed by finasteride oe dutasteride. The only advantage of shrinking the prostate is to reduce the instances of side effects of incontinence and ED of RP surgery. Of course, the use of hormone blockade medication, with all of the undesirable side effects for reducing prostate size (necessary for brachytherapy and radiation treatments) can be used, which will work faster.

Louis. . .

To: ProstateCancerSupport Sent: Sat, October 16, 2010 6:51:10 PMSubject: Re: Your opinion

Hi, you said :- > We are also aware that it makes it easier to see higher grade cancers, so that is not necessarily a bad thingI would argue it is possibly a bad thing. There is a danger of higher grade cancers being provoked by the treatment, for example:-

In 1998 researchers comparing finasteride to placebo observed that finasteride reduced benign prostate growth with .. a decrease in PSA of 48% ..

But look at the catch: of that finasteride treated group 30% had prostate cancer at the end of a twelve month trial. Whereas in the observation group (no finasteride treatment) one cancer in all was detected i.

This early finasteride trial anticipated the 2003 outcome of the much larger Prostate Cancer Prevention Trial (PCPT) which was abandoned, it now appears, for safety reasons. Both finasteride and dutasteride have been associated with suppressing PSA and reducing prostate volume. This may be advantageous for simple cases of BPH that do not have latent lesions or a malfunctioning estrogen receptor due to fetal developmental estrogenization (see articles section 5). The 5-alpha reductase inhibitors finasteride and dutasteride were designed to prevent the conversion of testosterone to DHT and so inhibit prostate growth and reduce PSA expression. Combined with an alpha-adrenoceptor blocker such as tamsulosin, efficient management of simple BPH may be obtained. However, reducing stromal prostate volume with 5αRI drugs may not have a good outcome where

there is latent prostate cancer, because growth control factors, including PSA, originate in the stromaii. Since BPH is neither the same as, or a precursor per se to carcinoma, the reduction of both BPH and subsequent PSA output achieved by 5αRI medications is unnecessary. More importantly however, removal of antiangiogenic components of PSA from the scene may trigger latent carcinoma to enter a more active phase that we see reflected in the increased number of higher grade carcinomas in 5αRI treated groups compared to placebo. Simply lowering PSA in this scenario is a false reassurance.

i Cote RJ, Skinner EC, Salem CE, Mertes SJ, Stanczyk FZ, BE, Pike MC, Ross RK. The effect of finasteride on the prostate gland in men with elevated serum prostate-specific antigen levels. Br J Cancer. 1998 Aug;78(3):413-8. PubMed:9703292

ii Briganti A, Chun FK, Suardi N, Gallina A, Walz J, Graefen M, Shariat S, Ebersdobler A, Rigatti P, Perrotte P, Saad F, Montorsi F, Huland H, Karakiewicz PI. Prostate volume and adverse prostate cancer features: fact not artifact. Eur J Cancer. 2007 Dec;43(18):2669-77. PubMed:17996442

-- Sam.http://fitcare.org.uk/epidemic/4.2.chemoprevention.update.html--- In ProstateCancerSupport , "LYNN" wrote:>> Hi Chuck,> > I have read all your responses to my proscar/avodart questions.> > I was just wondering what your thoughts were. My husband was diagnosed in March, 2010 with PSA of 7.5 and GS 4+3. He has no symptoms. After doing research (mainly through me), he decided that he didn't like any side effects and has decided to bide his time. Through diet and supplements, his PSA has dropped to 6.5. So, he is planning on waiting till a rise in his psa before he gets radical treatment.> > I know that there are no studies on how this affects men who aren't doing any other treatment, but I do know that all the studies shows that these drugs may slow down cancer growth. It is used for men to lengthen ADT holiday length

after failed surgery. Plus, of course, studies showed that there was less cancer in men who took the drugs (which indicates to me that it is slowing down growth, not stopping cancer)> > In the mean time, since he doesn't want any radical treatment, we were thinking, what can it hurt to try finisteride/dusteride? If he doesn't like the side effects, he can stop. > > We are aware that it would reset his psa for a new baseline, and if it changed from whatever the new number is, then he will have to do something. We are also aware that it makes it easier to see higher grade cancers, so that is not necessarily a bad thing.> > Please let me know if you have any thoughts on this. Our VA urologist wouldn't discuss the matter with us as he only wanted my husband to have treatment.> > Thank you for your time,> Lynn>

[Guest guest]

The U.S. National Cancer Institute published two short summaries

in 2008 of what was then known about the prevention of prostate

cancer by finasteride. See:

http://www.cancer.gov/clinicaltrials/results/summary/2008/pcpt0608

http://www.cancer.gov/cancertopics/factsheet/prevention/pcpt

I think of NCI as the single most authoritative source of

information since they vet their conclusions using a good sized

panel of international experts of whom, typically, about half are

academic scientists and half are practicing oncologists. In one

of the above documents they also cite an extensive bibliography

to support their conclusions.

They conclude that finasteride does have a preventive effect and

does not increase the number of high grade (aggressive) tumors in

men who do have or get prostate cancer.

I didn't see anything in the documents that addresses the

question of whether men who already have PCa will benefit from

finasteride.

Alan