My medical opinion of finasteride.

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Let me start by telling you a little bit about myself and what i'm doing here. I am a doctor, i teach pharmacology and internal medicine at medical school. I have a phD on medicine. I cannot reveal my name or other personal information because of my possible conflicted intrest with pharmaceutical company.
In my work i have seen increasing amount of people (especially young people) demandind propecia or proscar for MHB. Some of them had good information but others had :freaked2: .
The reason why i am here is because i want to share with you guys some medical facts about finasteride treating hairlose. I'm not here to judge but more give you my personal and medical opinion.

1. Propecia can’t be harmful because it has been used so many years as prostate medicine.

-Finasteride has been used primarily as Bening prostate hyperplasia treatment for 15 years. It’s effect is based on reducing the size of prostate and therefore minimizing symptoms caused by large prostate. There isn’t any evidence that finasteride reduce prostate cancer mortality since prostate cancer and prostate hyperplasia are two different things.

The reason why we can’t rely on the assumption that finasteride is safe even for the long period of time, is that main consumers of Proscar/Gefina are >50yr. males. Because cancer and cardiovascular risk always arise with age, we cannot performe a reliable long-term affect on those people. Elderly’s body go through a lot of changes and a big part of them will get cancers or/and cardio diseases, so we can’t know if it’s because of finasteride or just natural cause. Simply put, we do not know if finasteride has long term affect on other organs because there is no known scientific method to prove that. The only option is to wait and see.

Almost every medicine’s “bad†side-effects appears during regular use, not during clinical trials. The reason for this is that pharmaceutical companies just don’t have the volume of patient materials and time. It is known among pharmacologist that we can’t even start to begin to understand one medicine if it has less than 2million consumers. A good example is aspirin. When medical society first discovered that it has adverse effect on thrombosis, couple of thousands of doctors cross America started to use it in the hope of preventing blood clots. After a period of time doctors found that there are increasing amout of people dying at bleeding to the brain. Years later we found out that aspirin causes internal vascular haemorrhage. Lesson learned?



2. PCPT result of malignant prostate cancer (gleason score 7-10) is due bias error.

Although it is clear that a portion of the result can be explained by statistical error, but we have to keep in mind that not all cases are because of that. It is very well established among urologist that stastic can’t possibly explaine that amount of errors. The main reason for PCPT result is morelikely to be more complex.

Overall the significant increase of malignant cancer in finasteride users is a solid prove that we do not know the full “potential†of propecia. Although they used 5mg finasteride instead of 1mg(standard dose for alopecia) the effect aren’t considered too different from each other, since both PSA and prostate size are known to reduce almost a same amount. We have to keep in mind that propecia are used by healthy and young men. The cumulative affect on these people is widely unknown.

3. Finasteride can cause breastcancer

Although it is known that finasteride can cause gynecomastia (fat tissue and breastgland ductus hyperplasia), the relationship between finasteride and actual breastcancer has been considerd very loose. There are couple of reports of men with direct relationship with finasteride and breast cancer, but in scientific society, two is way too little. Nevertheless Propecia official webpage have recently added that “propecia have known to cause breast tissue neoplasiaâ€. Neoplasia is often a first sign of cancer when changes appear in regular cells (in this case, breast gland tissue) structure and morphology to more “indifferentâ€= not resembling the original tissue.

4. I’m not going to use finasteride for the rest of my life, cloning are coming!
The truth is that we are closer to walk on the face of mars than cloning hairs? Cloning are not even close of happening, the media give too bright future on that. It is really hard to say when cloning hairs is everyday thing, but it surely is not going to happen at least for about couple of decades. The permits for cloning itself is going to take another couple of years.

5. I’m not going to use finasteride, other drug will come!
It took us really long time to figure out that DHT has something to do with hairlost, so we’re going to stick on DHT-blockers for awhile, believe me!

Conclusion:
My medical opinion is that we can’t consider finasteride as the safest drug, because the term drug itself is dangerous. No drug, not even aspirin is safe in a long run. But at least aspirin is treated for an actual disease! I of course understand why people would like to restore its hair ( I would be lying if I say I don’t envy dr. shepherd from Greys’ anatomy), I just want to point out couple of truth so that everyone can make your own decision. As a doctor I don’t recommend finasteride for young patients because the truth is that it is going to affect you one way or another.

I hope you all very succeful year 2008 and good health!
May the hair be with you! :hairy:
 

bubka

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Newsflash "Doctor", studies have now shown that finasteride does not significantly increase the risk of malignant cancer, yes there was one initial study that showed that a few years back, but it has since been disproven

I think you watched too much Dougie Houser, you CANNOT be 23 years old and be a medical doctor, you are lucky to have a bachelors degree :whistle: let alone a medical doctor and teaching at a university

not trying to troll here, just do a search of your previous posts, you are all over the place about asking basic questions, and then you are giving us a "medical opinion" PLEASE
 
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And i didn't say i'm a professor, you know you don't need to be professor to teach. I'm assistant teacher.
As for the age: i am 23, skiped highschool. It takes five and half year to complete med school in Finland.
Again, i don't want to get personal here ( not interested). What i'm telling is my opinion, you can choose not to agree but i think we can all be sophisticated people about this.
 

bubka

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the point is, you say you are giving a "medical opinion" yet in other threads you are asking for a "medical opinion" on the SAME DRUG that you are criticizing

Finasteride Not Linked to High-Grade Prostate Cancers

Adapted from the NCI Cancer Bulletin, vol. 4/no. 25, Sept. 11, 2007 (see the current issue).

Finasteride is unlikely to induce high-grade prostate cancers in men who take the drug to prevent the disease, according to two studies released online Sept. 11, 2007, by the Journal of the National Cancer Institute (JNCI).

In 2003, the NCI-sponsored Prostate Cancer Prevention Trial (PCPT) found that finasteride reduced the overall incidence of prostate cancer by 25 percent, but was associated with a small increase in the number of high-grade cancers, which are often aggressive. It was not known whether the drug caused more high-grade prostate cancers or merely facilitated their detection. The new studies suggest the latter.

In the first study, Dr. Yael Cohen of Gamida Cell in Jerusalem and colleagues determined that finasteride reduces the volume of the prostate and therefore increases the likelihood of finding high-grade cancer cells in a biopsy. Finasteride accelerates the detection of high-grade cancer yet may not promote its development, they conclude.

The second study analyzed prostatectomies from the PCPT and found that the relative increase in high-grade tumors in the finasteride group was less than originally believed. The findings further suggest that enhanced detection may have contributed to the increase in high-grade disease in the finasteride group, reported a team led by Dr. M. Scott Lucia of the University of Colorado Health Sciences Center.

http://www.cancer.gov/clinicaltrials/re ... teride0907

You make so many other claim that are false that I don't know where to begin
 

Pondle

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buzz686 said:
Give me the research that says that!

Buzz, I think bubka is referring to the interpretation of the results of the PCPT.

http://jnci.oxfordjournals.org/cgi/cont ... 99/18/1366

"Conclusions: Although analyses using postrandomization data require cautious interpretation, these results suggest that sampling density bias alone could explain the excess of high-grade cancers among the finasteride-assigned participants in the PCPT."

Another source on the Mayo Clinic site (currently unaccessible) comments: "Dr Lucia, a pathologist involved in the PCPT, presented his opinions at the May 2005 annual meeting of the American Urological Association. If finasteride can produce tumor induction, the number of high-grade cancers would be expected to gradually increase over the duration of the study. This was not observed."

So there seem to be good reasons for being relatively relaxed about the supposed 'increased risk' of high-grade prostate cancer amongst finasteride patients.

BTW, as regards your medical credentials, I haven't seen any of your previous posts but - without wishing to cast aspersions - it's impossible to tell whether anyone posting on here really has any of the qualifications that they claim. I remember arguing with one guy who claimed to have "college-level research methods training", then promptly failed to understand the basic concept of statistical significance! :crazy:

Obviously everyone is entitled to their opinion, whoever they are and whatever their degree of knowledge. I myself am just an interested layman and fellow balding geezer!
 
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i don't believe for one second that this guy is a doctor. just another anti-propecia guy in my opinion. if he won't give his name then his medical credentials are irrelevant.

Buzz's first post on here ever:

Hi guys. I have used propecia 1mg every day for about a week now and i just noticed my breast is growing. Should i stop using propecia altogether or reduce my dose to 0.5mg per day? please help me, freaking out now!!!

That's from June 2007. So in that time you have managed to become a propecia expert and are now proclaiming that you are also a medical doctor who teaches pharmacology and internal medicine? give me a f*****g break.

cassin please ban this guy
 

Cassin

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buzz686 said:
possible conflicted intrest with pharmaceutical company.

Then you can't be here and have violated the terms of use with this website that you agreed to. DO NOT COME BACK HERE.

And guys...never believe anyone is a doctor on these boards unless they site owner confirms it.

No doctor is going to post on a forum without reaching out to the owner first. Or at the very least, a mod.
 
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