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finasteride
  • darwindarwin
    Posts: 1,195
    i saw an article in the NY Times today mentioning that a low dose daily course of finasteride can reduce likelihood of prostate cancer by 30%

    anybody have any experience with it or know about it?

    darwin
  • mog
    Posts: 149
    Hi Darwin :)

    >anybody have any experience with it or know about it?< (Finasteride)

    Yes, I've been on it for a couple of years. 'Twas given me for a benign prostate condition.

    It takes a while to work but it gradually shrinks the prostate, freeing up the waterworks, and therefore can delay the need for a drilling-out operation by a few years, or in some cases completely avoid the need for an operation.

    It seems to have no bad effect upon my MMO practice - it might have even enhanced it - who can tell!

    Google will tell you more.

    Mog
  • alvalv
    Posts: 179
    mog - now what has freed your waterworks : Finasteride or Aneros massage?

    By the way, pumkin seed and pumkin seed oil are said to have the same property. Pumkin seed oil in a salad is delicious.
  • mog
    Posts: 149
    hi Alv :)

    >mog - now what has freed your waterworks : Finasteride or Aneros massage?<<br />
    Hard to say now with any certainty. But as I've never used the Aneros much - not on a daily basis at all - maybe once or twice a month - it might seem that the Finasteride has been largely beneficial. However, as I'm doing OK at present and the drug comes foc on our national health I'm happy.

    >By the way, pumkin seed and pumkin seed oil are said to have the same property. Pumkin seed oil in a salad is delicious.<<br />
    I've never tried PSO but I shall look for some tomorrow - thanks for the tip.
  • I have also been on Proscar (Finasteride) for approximately 6 months. My urologist prescribed it after laser surgery for BPH. He said that even though the surgery was a success, the prostate will continue to grow if nothing is done.

    He started me on Avodart (Dutasteride). It is a similar drug (more expensive) that is normally well tolerated. It has a long half-life which means that it must be taken for 5 weeks or so before having an effect. When the itching broke out (after approximately 5 weeks) I didn't put the two together. Usually side effects from a drug occur quickly, but not in my case. Of course with a long half-life, it took 5 weeks for the itching to totally go away. I tried it a second time and experienced the same results. This is extremely rare, but I was just not able to tolerate the drug.

    I have been on Proscar (Finasteride) since with absolutely no side effects. I go back next month for a follow-up.
  • rookrook
    Posts: 1,603
    Thoughts on bph, PSA and Finasteride:

    Unless you are genetically pre-disposed to PCa AND your doc is nearly adamant about it, I'd suggest thinking long and hard before seeking out Avodart or Finasteride.

    This is the med that pregnant women cannot even touch for fear that a male fetus will develop deformed genitals. At 1mg/day the side effects don't reach a statistical level but at 5mg/day it definitely begins to show up on the side-effect radar.

    Check out: http://men.emedtv.com/finasteride/finasteride-side-effects.html I pulled this site strictly at random from Google -- it may be unfairly negative but is representative of what guys who visit the ASI groups have experienced. I help in the Yahoo impotence group and we occasionally get guys there that have been on Finasteride and their E.D. recovery is slow and the damage lingers.

    My early approach (12 years ago with a 50+ gram prostate) was Saw Palmetto (2-3 caps per day) for five years. Then a homopathic doc suggested combining it with Pumpkin Seed Extract. That dropped my PSA from 1.75 down to 1.3 and yielded a size of <50gm.) At seven years my Uro switched me from Saw to 1mg of alfa-blocker daily and that held me for another six years. When I get 'tight' I add some Saw + Pumpkin Seed Extract for a couple of days or up the Hytrin to 2 mg for one day. Prostate massage (Aneros aerobics) seems to have obviated the regular need for any supplement beyond a single mg. of Hytrin each day. Right now my prostate is estimated at 45 grams and is stable.<br />
    My own hunch is that Saw + Pumpkin Seed Extract + regular Prostate Massage would be the best therapy for moderate enlargement.

    A dozen years ago there was a consensus that lateral lobe enlargements and bladder neck issues responded to Saw Palmetto whereas Medial enlargements did not. My own enlargement was originally diagnosed as "a left lobe bulge" and Saw + Pumpkin Seed Extract worked for me.

    The 'lateral lobe' versus 'medial enlargement' opinion no longer seems to be discussed on the sci.med.prostate.bph website. So, I don't know where this discussion might stand today.

    A healthy diet, avoiding toxic chemicals -- particularly defoliants and hormone treated dairy and meat is the best bet. Staying slim (to keep Estradiol // E2 under 53 and total Estrogen between 40 and 115) seems to help.

    There is some thought that elevated E2 may be a precursor (no one seems to know whether it's an indicator or causative factor) to PCa. The emerging definitive test for PCa checks for ejaculate citrate levels rather than PSA. Once we find out why citrate level changes we may be on to some causative factor -- probably not in my lifetime.

    Check out Dr. Eugene Shippen's book "The Testosterone Syndrome." I recommend reading all of Chapter 8. Shippen was once considered radical (his book is now a decade old) on the topic. Now, he's getting some recognition for 'being right all along.'

    The bottom line -- if Testosterone was bad, we'd all die young, when our levels were very high.
  • Rook,

    By PCa do you mean Prostate Cancer? If so, I am not predisposed to it. No family history.

    Urologist had me on alpha-blocker prior to the surgery and I had problems with wild blood pressure fluctuations. It also didn't appear to help.

    I tried taking pharmacuetical grade Saw Palmetto, but it didn't have any appreciable benefit.

    I haven't tried pumpkin seed extract. Is this available in a pill or liquid? It would be worth a try.

    Thanks in advance.
  • rookrook
    Posts: 1,603
    Serenity said:

    Rook,

    By PCa do you mean Prostate Cancer? If so, I am not predisposed to it. No family history.

    Urologist had me on alpha-blocker prior to the surgery and I had problems with wild blood pressure fluctuations. It also didn't appear to help.

    I tried taking pharmacuetical grade Saw Palmetto, but it didn't have any appreciable benefit.

    I haven't tried pumpkin seed extract. Is this available in a pill or liquid? It would be worth a try.

    Thanks in advance.



    --Sorry for the abbreviation. Yes PCa= prostate cancer
    --I'm lucky that 1 or 2 mg of alfa-blocker (Hytrin) does the deed. I keep the alfa blocker >4hrs from any vasodialator like Viagra, Levitra etc. Uro and PC doc say no Cialis with Hytrin. I also avoid taking it at bedtime when I take Niaspan. I've twice ignored this guidance and have twice blacked out when standing up. I've not yet figured out how it does/doesn't affect an Aneros session.
    --My impression is that an alfa-blocker takes less of an E.D. hit than did the Saw--Pumpkin combo. Other guys haven't noticed this difference.
    --If the old wives tale about medial/lobe enlargement was true, you may have an enlargement that Saw wouldn't help. Mine is lateral w/bladder neck stress.
    --Our D.O. doc sent me to a Health Food store that carried Pumpkin Seed Extract liquid in gel caps. Two a day and $10 bucks bought 90 caps. Doc's caution was to not take selenium or zinc as the extract has plenty.
    --Never took pumpkin separately, just with Saw Palmetto.
  • B MayfieldB Mayfield
    Posts: 2,077
    I remember some years ago when I was first introduced to finasteride in a dermatologist's office. At the time it was being promoted as the newest thing for hair growth. As many of you may know, a side of effect of this medication is hair growth and like Minoxidil before it, it was being re-branded for men eager to address male pattern baldness.

    While the dosage for this application was considerably lower than that for BPH, the warnings and contraindications (many of which Rook has covered) were still there. While these issues have been known for years, there is a newer one that is even more unsettling. As it turns out there is some indication that finasteride may mask ones PSA levels, with the effect of producing an artificially low number....NOT a good thing! One researcher suggests that men taking finasteride should TRIPLE their PSA numbers to arrive at a more accurate figure. Apparently the masking effect lasts for months after one discontinues use of the drug as well.

    The following link addresses the New York Times article that Darwin referred to directly and should, IMO, be seriously considered by all men currently taking finasteride or those who are thinking about it. If you're using this for hair re-growth....what cost vanity?

    http://urology.jhu.edu/newsletter/2009/prostate_cancer_2009_10.php



    BF Mayfield
  • Thanks BF.

    The following statement in the Johns Hopkins article is a bit confusing to me:
    As a treatment for BPH, finasteride is fine, Walsh says, as long as men who are being screened for prostate cancer understand the guidelines (see box).
    [box]
    Will the Real PSA Number Please Stand Up?

    If you are taking finasteride, you need to be able to determine your actual
    PSA number.
    If you have been taking the drug for:

    Two years: Multiply your PSA by 2,
    Between two and seven years: Multiply your PSA by 2.3
    More than seven years: Multiply your PSA by 2.5

    If your PSA begins to rise: Get a biopsy immediately. Your risk of having
    cancer is three times higher than that
    of men without a rising PSA, and your risk of having high-grade cancer is six times higher.

    [box end]

    My urologist is the highest rated by his peers locally. He was recommended years ago by my internist, who has an excellent record with his recommendations to other physicians. I have a high level of confidence in both of them.

    I became involved with the info from Johns Hopkins when I was considering the prostate surgery. I follow up with their latest news via their emails regarding prostate updates. I receive 2 to 3 emails weekly from JH. I try to stay out of the dark. One of JH's recommendations is to pay more attention to PSA rises than to actual PSA numbers. Increases in PSA (even if the number is "good") are to be of concern. This is true regardless of meds.

    My urologist told me point blank prior to use of both Avodart & Proscar (Finasteride) that it would definitely skew PSA results. He said absolutely nothing about it preventing prostate cancer! I have personal reservations about taking any drug that a person of the opposite sex is not allowed to even touch!

    My question during the follow-up exam is "Has Finasteride been effective in reducing (or at least maintaining) my prostate size?" If not effective, I will probably quit taking it.

    I plan to pick up some bulk pumpkin seeds tomorrow for munching. I know those are safe!
  • B MayfieldB Mayfield
    Posts: 2,077
    Serenity,

    It sounds like you're keeping abreast of things, which is very, very good. Please understand my intention was not to scare anybody here, but to make people really consider what they are doing. It's a bit alarming when a major newspaper comes out with an article which would likely have the effect of spurring men to take this drug, only to find that it may lead to more cases of cancer going undetected longer.

    In so far as the formula that they're providing here, one thing is clear, it becomes more difficult to ascertain ones true PSA level while taking these drugs. Please understand that I wasn't casting aspersions on your doctor here at all either. As I've always said, I am not a doctor, and none of the information that I or others offer here should be used as a basis for diagnosing oneself. Such information can however form the basis for questioning your doctor. Satisfy yourself that you're receiving all of the information you need and then (and only then) make a decision about what is right for you.

    One other thing, one of the reasons that I've lent so much credence to this article is that it comes out of John's Hopkins.....a facility known for being on the cutting edge of research in this area. Could they have got it wrong. Certainly, but I'd say this, they've gotten things right often enough in the past that I would seriously consider these findings.

    On the rise vs. the level, you're absolutely correct about this and thank you for pointing it out.


    BF Mayfield
  • rookrook
    Posts: 1,603
    PSA contribution by the Cowpers:

    While doing some research on precum I found this: http://en.wikipedia.org/wiki/Bulbourethral_gland

    Check the last sentence in the section titled "Function."

    (Note: that this wikipedia article is short on references.) And, remember that not all tumors are malignant--perhaps a benign tumor could be at fault.

    I look forward to the more definitive and quicker citrate test:
    http://www.sciencedaily.com/releases/2009/05/090518213945.htm

    My Uro made favorable mention of the citrate test earlier this year. One issue is that the cost can be quite low if performed on semen but much higher if performed on prostate fluid obtained with a local and a biopsy needle.

    Decisions -- decisions ..... :oops: :roll: :shock: :D
  • hulahula
    Posts: 212
    I was prescribed finasteride (proscar) and flowmax a few years ago. It made me feel depressed and fat. I definitely think it was affecting my testosterone levels. I complained to the urologist, and he took me off reluctantly. I went to a second urologist, and he just has me on flowmax. I still have incomplete emptying, but we are conservatively watching it. I also have a tablespoon a day of pumpkin seed oil, which I buy in a gourmet food store. It actually tastes pretty good. My psa was extremely low the last time I was tested.
  • slimjm
    Posts: 497
    I don't want to jump in over my head here as I'm not a urologist, but as a real life doc doing primary care and treating men's health problems I want to contribute any helpful information I can to this already excellent discussion.

    As I understand it, at the American Urologic Association's 104th annual scientific meeting, results were presented from a study of chemoprevention in prostate cancer showing that Avodart (dutasterine) lowered the risk of prostate cancer by 23%, with the risk for developing high grade tumors being reduced in particular. This is thought to be due to the fact that Avodart inhibits both the Type 1 and Type 2 variants of the 5-alpha reductase enzyme that converts testosterone to dihydrotestosterone in the prostate. Supposedly, inhibiting the Type 1 variant of this enzyme provides the greatest benefit against high-grade tumor cells and Proscar (finasteride) is only able to inhibit the Type 2 variant.

    As my memory serves me, Proscar was thought to be of benefit in preventing prostate cancer from studies conducted some years ago with this drug, but not against higher grade tumors, though at the time there was some discussion that it was the effect of the Proscar itself upon the cells as viewed under the microscope and not that higher grade tumors were developing with Proscar.

    My thoughts about using these drugs, based upon what I see most urologists doing (and this is more the art of medicine than science at the present time as we wait for more data to come in), is that if you are at an increased risk of developing prostate cancer, e.g., you have an enlarged gland with a 'borderline' high PSA even in the face of a negative prostate biopsy, you probably ought to be on one of these medications, and in view of the most recent data, that would be Avodart (as opposed to the older, now generic--and cheaper--Proscar or finasteride). Anything beyond that gets into softer areas where personal decision making comes into play.

    As an illustration, in my specific case, now at over 50 and with my father having had severe prostate enlargement requiring open prostatectomy with complications in his 50's (years ago when we had none of these treatment alternatives) and then developing prostate cancer in his 70's requiring radiation treatment (which thank the Lord he is disease free 10 years later), I made the decision some years ago with my urologist, even with a normal prostate gland size and PSA at the time, to take Avodart. I've felt no ill effects from it, my annual checkups are fine, and I figure I don't get the option if I didn't take it and then ran into problems down the road (given my family history) to roll the clock back and try it all over again taking it, but that's personal and I don't necessarily recommend this to others. And yes, it did stop my hair loss that was starting at the time.

    Watching the PSA is usually not complicated on these medications. I just attended another urologic meeting about 2 weeks ago and the comments made there reflect those already presented in this forum. You generally double the PSA on the medications to determine your true or untreated PSA and it is your PSA trajectory over time--whether on or off the drugs and even within the 'normal' ranges--that can be of more significance than absolute values.

    As to side effect considerations, a small number of those taking these medications can develop breast tenderness which I understand occurs early on it it's going to and in which case the medication should be stopped. A decrease in the volume of ejaculate can occur and erectile problems can occur in about 6%. The issue about women handling the drugs or having sex with a man taking the drug and ejaculating his semen into her (these drugs are concentrated in the semen) is that these medications can conceivably prevent normal male development in the unborn male fetus. Other than that, if you take these medications, you will not be permitted to donate blood for the same reason.

    Though I am no authority in this area, hope this is helpful.