Propecia Research Today is a free monthly online journal that collates and summarizes the latest research about Propecia, including details on baldness, hair loss, side-effects, results.

Finasteride to Prevent Prostate Cancer: Should All Men or Only a High-Risk Subgroup Be Treated?

Vickers AJ, Savage CJ, Lilja H

Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY.

PURPOSE: Finasteride has been shown to reduce the incidence of prostate cancer. Yet the use of finasteride remains low, likely because of the risk of adverse effects. We sought to determine whether prostate-specific antigen (PSA) levels could identify a high-risk subgroup for which the benefits of finasteride treatment outweigh the potential harms. PATIENTS AND METHODS: Raw data from the Prostate Cancer Prevention Trial were used to model chemopreventive treatment strategies: treat all men, treat no men, or treat a high-risk subgroup based on PSA level. We weighted the benefits (reduction in cancer rate) and harms (treatment rate) of each strategy using numbers-needed-to-treat thresholds-the maximum number of men a clinician would treat with finasteride to prevent one cancer. RESULTS: Of 9,058 men, 1,957 were diagnosed with prostate cancer during the 7-year study. For the end point of all cancers, including both for-cause and end-of-study biopsies, the optimal strategy is to treat all or nearly all men. To reduce risk of cancers detected through routine care, treating men with PSA > 1.3 or > 2 ng/mL is optimal. For example, treating only men with PSA > 2 ng/mL reduced the treatment rate by 83% and resulted in a cancer rate only 1.1% higher than treating all men. CONCLUSION: Clinicians wishing to reduce the risk of any biopsy-detectable prostate cancer should recommend finasteride to all men. Clinicians who believe that it is unnecessary to prevent all cancers, but that preventing those readily detectable by screening would be desirable, would be best off recommending finasteride only to a high-risk subgroup.

Published 3 February 2010 in J Clin Oncol.
Full-text of this article is available online (may require subscription).

Articles on Propecia published 1 February 2010:

Replacement with GABAergic steroid precursors restores the acute ethanol withdrawal profile in adrenalectomy/gonadectomy mice.   Neuroscience, 166(1): 5-14.

The neurosteroid allopregnanolone (ALLO) is a progesterone metabolite that is one of a family of neuroactive steroids (NAS) that are potent positive allosteric modulators of gamma-aminobutyric acid(A) (GABA(A)) receptors. These GABAergic NAS are produced peripherally (in the adrenals and gonads) and centrally in the brain. Peripherally produced NAS modulate some effects of ethanol intoxication (e.g., anxiolytic, antidepressant, and anticonvulsant effects) in rodents. We have found that NAS also ... [Abstract] [Full-text]

Articles on Propecia published 29 January 2010:

An overview on 5alpha-reductase inhibitors.   Steroids, 75(2): 109-53.

Benign prostatic hyperplasia (BPH) is the noncancerous proliferation of the prostate gland associated with benign prostatic obstruction and lower urinary tract symptoms (LUTS) such as frequency, hesitancy, urgency, etc. Its prevalence increases with age affecting around 70% by the age of 70 years. High activity of 5alpha-reductase enzyme in humans results in excessive dihydrotestosterone levels in peripheral tissues and hence suppression of androgen action by 5alpha-reductase inhibitors is a ... [Abstract] [Full-text]

Articles on Propecia published 25 January 2010:

Treatment with progesterone after focal cerebral ischemia suppresses proliferation of progenitor cells but enhances survival of newborn neurons in adult male mice.   Neuropharmacology.

Stroke stimulates cell proliferation in the subventricular zone (SVZ) and hippocampal dentate gyrus (DG) in adult rodents and humans. However, most newborn cells will die within 1-2 weeks. We recently have revealed that progesterone (P4) promotes the survival of newborn neurons in the DG and improves the neurological dysfunction after cerebral ischemia. The aim of this study was to further explore the effects of P4 on the ischemia-induced neurogenesis in the DG, SVZ and striatum. ... [Abstract] [Full-text]

Anti-androgen Treatments.   Ann Endocrinol (Paris).

1. Estrogen plus progestin contraceptives (EPP) are the first-line treatment of moderate hirsutism and acne in women of child bearing age (grade C). 2. CPA, 50mg/day, 20 days out of 28, associated with estrogen is the first-line treatment of "moderate to severe hirsutism" in women of childbearing age (grade C). 3. Spironolactone, given as a contraceptive, can be proposed as a second-line treatment in case of side effects or counter-indications to CPA in moderate to severe hirsutism ... [Abstract] [Full-text]

A Pilot Study of Paternal Drug Exposure: The Motherisk Experience.   Reprod Toxicol.

BACKGROUND: There is a dearth of information on paternal drug exposure at the time of conception. The Motherisk Program, established in 1985, is a teratology information and clinical consultation service on drug safety during pregnancy and lactation, as well as paternal exposure (PEx). Here, we reviewed for the first time our experience with PEx. METHODS: This was an observational retrospective cohort study using a prospectively collected database. Telephone counselling records from January ... [Abstract] [Full-text]

Articles on Propecia published 13 January 2010:

A liquid chromatography/tandem mass spectrometry method for determination of aristolochic acid-I in rat plasma.   Biomed Chromatogr, 24(2): 174-9.

A sensitive, rapid and specific liquid chromatography-electrospray ionization-tandem mass spectrometry method was developed and validated for the determination of aristolochic acid-I (AA-I) in rat plasma. Finasteride was used as the internal standard (IS). The analyte was separated on a Zorbax Eclipse XDB-C(18) column by isocratic elution with methanol-10 mM ammonium acetate (75:25, v/v, pH = 7.3) at a flow rate of 0.25 mL/min, and analyzed by mass spectrometry in positive multiple reaction ... [Abstract] [Full-text]

Articles on Propecia published 11 January 2010:

Effect of spinal cord injury upon prostate: adenocarcinoma of prostate in a spinal cord injury patient - a case report.   Cases J, 2: 9374.

INTRODUCTION: Following spinal cord injury, prostate undergoes atrophy probably due to interruption of neuro-hormonal pathways. The incidence of carcinoma of prostate is lower in patients with spinal cord injury above T-10 than in those with lesion below T-10. CASE PRESENTATION: A Caucasian male sustained T-4 paraplegia in 1991 at the age of 59-years. He had long-term indwelling urethral catheter. In May 1995, routine blood test showed prostate-specific antigen to be 17.7 mg/ml. Prostate biopsy ... [Abstract] [Full-text]

Articles on Propecia published 28 December 2009:

Prolongation of off-cycle interval by finasteride is not associated with survival improvement in intermittent androgen deprivation therapy in LNCaP tumor model.   Prostate, 70(2): 147-54.

BACKGROUND: We have previously reported that finasteride administration in intermittent androgen deprivation therapy (IADT) can improve survival of nude mice bearing LNCaP xenograft tumors when the duration of off-cycle in IADT was fixed. A recent retrospective study showed that addition of finasteride doubled the duration of the off-cycle, without changing progression to castration resistance. In view of the above difference, we attempted to investigate the relationship of 5alpha-reductase ... [Abstract] [Full-text]

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