Warnings and Advice Needed (All finasteride and dutasteride users)

[StoptheMadness]

I went to the dermatologist today (he has been prescribing my propecia for the last 3 years now). I asked him about dutasteride, he knew of it of course, but wasn't sure if it was approved by FDA yet. So he consulted his FDA approved Medication Book for 2006 and sure enough it was approved.....Even so he warned me against taking dutasteride due to this study done in the New England Journal of Medicine 2003:

Conclusions of a trial done by Thompson I.M. et al in the New England Jorunal of Medicine 2003; 349:215-224, in an article titled "The influence of finasteride on the development of prostate cancer".....finasteride prevents or delays the onset of low-grade prostate cancer, WHILE SLIGHTLY INCREASING THE RISK OF MORE AGGRESSIVE-APPEARING (HIGH GRADE) CANCER. The aggressiveness and outcome of the tumors were not addressed. Five deaths from prostate cancer occurred in this trial in both the finasteride and placebo groups. PATIENTS ON finasteride 5MG (PROSCAR) DAILY SHOULD WEIGH THE CANCER AND URINARY SYMPTOM REDUCTION AGAINST THE SIDE EFFECTS OF A MORE AGGRESSIVE-APPEARING (HIGH GRADE) PROSTATE CANCER INCREASE. finasteride 5mg (Proscar) was given but no finasteride 1mg (propecia) was given in this study. finasteride 5m produces more androgen suppression in serum and prostate than finasteride 1mg (Propecia). It is therefore unclear whether Propecia will significantly influence prostate cancer. Further research is needed. Propecia patients need to be informed abouth these issues.

My derm will still give me the go ahead for Propecia but certainly not for dutasteride, due the unknown. He at least believed that 4 years or so should pass before he would even think about prescribing something so powerful to the hormones. I am conflicted b/c finasteride is losing its efficacy and I would like to use something only FDA approved. But jumping blindly into something like dutasteride might have SERIOUS consequences (i.e. aggressive prostate cancer when 40 yrs old). People on this forum say its ok and it works for them when taking dutasteride, and this may be true, but they are gambling with something they do not know enough to realize what it might do to their body.

• t

 

[Aplunk1]

Don't forget that these drugs were developed for treating BPH, and that most of the men who were tested (50+ years of age) already had some form of prostate cancer in addition to an enlarged prostate.

Your Doctor probably didn't take this into consideration.

 

[lithebod]

this article published in October 2005 discusses the issue relating to finasteride and the risk of developing aggressive prostate cancer - for those who dont wish to read the whole thing it ends with the following:

"Bottom Line: Although the evidence is still being weighed, currently the preponderance of evidence suggests that finasteride treatment does not lead to the development of more aggressive prostate cancer."

http://seattleprostateinst.com/pca-arti ... e10-05.htm

 

[StoptheMadness]

Don't forget that these drugs were developed for treating BPH, and that most of the men who were tested (50+ years of age) already had some form of prostate cancer in addition to an enlarged prostate.

Your Doctor probably didn't take this into consideration.

Not true, the 18,882 men aged 55+ had normal prostate glands.

For a Dr. who might dispense Dutasteride, they might take into consideration that the study still seems inconclusive. This due to the fact a larger percentage of men had more aggressive tumors when taking finasteride versus taking a placebo.

 

[Freestyle]

Everything gives you cancer these days.

Experts believed Hot Dogs could increase the likeliness of Leukemia a few years back. Sugarless gum will give you cancer. Scratching a mole consistently will make it cancerous. Beating your testicles with a wooden clog will give you cancer.

Maybe these assholes should stop looking for the billion remote ways you could get cancer, and spend their time and grant money on finding a cure for the sh*t.

I'm gonna go get a hot dog. And a wooden clog.

 

[iamnaked]

Everything gives you cancer these days.

Experts believed Hot Dogs could increase the likeliness of Leukemia a few years back. Sugarless gum will give you cancer. Scratching a mole consistently will make it cancerous. Beating your testicles with a wooden clog will give you cancer.

Maybe these assholes should stop looking for the billion remote ways you could get cancer, and spend their time and grant money on finding a cure for the $#iT.

I'm gonna go get a hot dog. And a wooden clog.

Great post. Most medical authority figures I have spoken to find it very hard to provide people with predictions about the benefits of following a 'healthy' lifestyle (cutting out everything we are told is bad for us) because they have had so much experience of cases which defy received wisdom. So much is determined by your genes - you can smoke til' your 80 or be a teetotal vegetarian and still get that aggressive lung cancer which does for you in your 40's.

As regards the original post, I find it highly implausible that there's a causative link between aggressive prostate cancers and 5-AR blockers. I would rather hazard a guess that it is the reduction in prostate-specific antigen which the blockers cause (a marker for the cancer) which is to blame, i.e. it masks the cancer.

 

[StoptheMadness]

Out of all the people who developed cancer, the study showed that the one's who took Proscar (versus a placebo) were the ones who developed a more aggressive form of prostate cancer. The study is totally inconclusive as to whether finasteride causes cancer. But the annals now at least recognize that Proscar is not something to take lightly (and to say nothing of dutasteride).

Believe me, I want to take dutasteride, but am just not sure. I think it's only approved by the FDA for cancer, but not hair loss? I am not sure. I emailed one doctor in the area that I found thru the web (Chicago) and he replied that he does dispense dutasteride but makes his patients sign a waiver, having the understanding that dutasteride is not approved yet by the FDA. This sh*t is highly potent and ultimately we are gambling that "its ok." On the other hand my regular derm will not even dispense this because of the unknown (whereas minoxidil and Propecia are "knowns" - well Propecia still might have unknown side effects for long term use).