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Propecia, Balding, and Prosate Cancer

This month’s newsletter is about a drug called Propecia that we often use to treat male pattern baldness. New studies on this drug reveal that it may protect men against prostate cancer.

What does Propecia have to do with your prostate?
Propecia (generic name = finasteride) was originally a medicine used to treat BPH (benign prostate hypertrophy). BPH is a very common enlargement of the prostate that happens in older men and leads to urinary symptoms. Finasteride at a 5mg dose helps to relieve this condition by shrinking the prostate. Several years ago, some observant doctors noticed that their balding patients started growing hair while on finasteride. Tests were done to find the lowest dose necessary to grow hair, and the results showed that 1mg was just as good as 5mg, but with fewer side effects. So Propecia is a 1mg finasteride pill used to treat male pattern baldness, while Proscar is a 5mg finasteride pill used to treat BPH. All of the studies below refer to data in men using 5mg of finasteride.

Does finasteride protect men against prostate cancer?
The answer is “probably”. But for years the message was mixed: while finasteride use may reduce the overall risk of prostate cancer, it is associated with an increased risk of high-grade disease. Recently, the data on this subject was reanalyzed in a new study where the authors found no elevated risk of high- grade prostate cancer with finasteride use. I will present the information to you, but remember that all of the data is from tests done with the 5mg dose of finasteride, while Propecia is a 1mg dose of finasteride.

Lets start from the beginning:
In 2003 the results from the Prostate Cancer Prevention Trial (PCPT) demonstrated a 25% reduction in the prevalence of prostate cancer among patients treated with finasteride compared with patients treated with placebo. However, there was a 22% increase in high grade (i.e. “worse”) tumors. In other words, the men taking finasteride had a lower overall chance of getting prostate cancer, but the ones who got the cancer had a potentially worse kind. This was a confusing message for both doctors and patients: “take finasteride and you are less likely to get prostate cancer, but if you do ultimately get the cancer, it may be worse”.

In 2007 a re-analysis of the data:
In 2007 the data was looked at again. The scientists hypothesized that finasteride use does not cause high- grade prostate cancer, but rather shrinks prostate volume, making advanced disease easier to detect. In analyzing data from nearly 1000 men enrolled in PCPT, the researchers found that prostate volume was, in fact, reduced with finasteride use. The average volume in users of the drug was 25% lower than in subjects given placebo. After adjusting for prostate size, the authors found no elevated risk of high-grade prostate cancer with finasteride use.

Does this data tell us anything about Propecia which is 1mg of finasteride?
The real answer is, “we do not know”. Perhaps protecting men against prostate cancer is analogous to growing hair, where 1mg is just as effective as 5mg. Perhaps it is analogous to treating BPH, where 5mg is superior. What we do know is that the new data is reassuring and suggest that if there is any effect on prostate cancer in men taking Propecia, it is only a benefit and not a negative effect.

Read more about using Propecia for male pattern balding…

Sincerely,
The Staff and Doctors at Minars Dermatology
email: tminars@hotmail.com
phone: 954-987-7512

In This Issue
What does Propecia have to do with your prostate?

Does finasteride protect men against prostate cancer?

Lets start from the beginning:

In 2007 a re-analysis of the data:
Does this data tell us anything about Propecia which is 1mg of finasteride?

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Whenever I write about the Vitalize Peel I get several questions. I will try here to pre-empt them. The peel cost is $175. You look great for two days and then on day 3 you start to peel and you will continue to peel for 5 or 6 days (and then you will look great again.)

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