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Does Finasteride Cause High Grade Prostate Cancer

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Why Does Finasteride Continue To Be Sold


Despite the evidence, and until the medical debate is solved, Finasteride continues to be sold, and warning labels are placed in certain countries as a warning against the post-finasteride syndrome

It is sold as both a solution to relieving symptoms of benign prostatic hyperplasia and male balding. Health market research firm IQVIA says that approximately 570 million Finasteride tablets were dispensed in the United States alone between April 2017 and April 2018.

Merck, the pharmaceutical company that manufactures and sells finasteride, has stated: We do not believe that reliable scientific evidence supports the existence of Post-Finasteride Syndrome. Merck stands behind the efficacy and safety profile of Propecia..

Yet despite this statement, over 1,4000 lawsuits have been filed against Merck in the United States and Canada since 2011.

Moreover, these lawsuits have claimed permanent sexual problems, cognitive impairment, and depression. In 2012, the company was forced by the FDA to change the wording on Propecia labels regarding side effects from temporary to persistent .

Finasteride Can Safely Cut Prostate Cancer Risk

HealthDay Reporter

THURSDAY, Jan. 24, 2019 — Finasteride, best known as the enlarged-prostate medicine Proscar, is a safe, effective way to reduce the risk of prostate cancer, according to long-term findings from the Prostate Cancer Prevention Trial .

The trial was funded by the U.S. National Cancer Institute and enrolled nearly 19,000 men between 1993 and 1997.

Initially it found that finasteride — a hormone-blocking drug — cut the risk of prostate cancer by 25 percent. Those results were published in 2003.

The newly released long-term data show that the reduction of prostate cancer risk has continued and that fewer than 100 men in the trial died from prostate cancer in more than two decades of follow-up, according to a research team led by Dr. Ian Thompson.

The updated results also showed no statistically significant increased risk of death from prostate cancer among men taking finasteride. This removes concerns over early findings of a possible risk of more aggressive cancers among patients who take the drug.

“Finasteride is safe, inexpensive and effective as a preventive strategy for prostate cancer,” said Thompson, who is principal investigator of the PCPT for the SWOG Cancer Research Network.

The SWOG Cancer Research Network is an international cancer clinical trials group.

Thompson is also emeritus professor at the University of Texas Health Science Center. He and his team published their findings Jan. 23 in the New England Journal of Medicine.

Data Extraction And Statistical Analysis

Data were extracted from the studies by 3 reviewers and included demographic data , prostate cancer outcome data and the number of high-grade prostate cancer cases. Disagreements were resolved by consensus. Quantitative meta-analysis was performed by 2 reviewers using Review Manager software and Stata software . The available data were analyzed in the meta-analysis.

To calculate the combined OR and its 95% confidence interval , heterogeneity was assessed using P-values and the I-square statistic in the pooled analyses which represents the percentage of total variation across the studies. If the P value was less than .1 or the I2-value was greater than 50%, then the summary estimate was analyzed in a random-effects model. Otherwise, a fixed-effects model was applied. In addition, publication bias was detected by visual examination of the funnel plot symmetry, with asymmetry suggesting possible publication bias. It was also assessed by the Begg and Egger test in the meta-analysis. If the P value was less than.05, then publication bias existed.

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Does Propecia Cause Side Effects

Propecia is used to treat male pattern baldness or androgenetic alopecia in males only. Propecia works by lowering levels of a hormone that shrinks hair follicles, called dihydrotestosterone .

It slows hair loss in about 88% of men and helps hair regrow in about 66%. Another finasteride oral dosage form, Proscar or 5 mg finasteride tablets are FDA approved only for the treatment of benign prostatic hyperplasia and should not be used for androgenetic alopecia. Do not confuse these finasteride tablets.

Common side effects of Propecia include

  • breast enlargement,

Serious side effects of Propecia include

Drug interactions of Propecia include carbamazepine, rifampin, and St. John’s wort, which may reduce blood levels of Propecia by increasing its breakdown in the liver. Itraconazole, erythromycin and similar drugs increase blood levels of Propecia.

Propecia should not be used or handled by pregnant mothers due to the potential hazard to the male fetus. Propecia prevents the conversion of testosterone to DHT, a hormone which is necessary for the development of male genitalia.

It is not known if Propecia is excreted in breast milk. Propecia is not indicated for use by women and should not be used while breastfeeding.

Can Prostate Cancer Be Prevented

Finasteride as a Chemopreventive Agent in Prostate Cancer

Principal investigator Ian Thompson, M.D., sorts out the Prostate Cancer Prevention Trials findings and outlines finasterides risks and benefits

For men diagnosed with prostate cancer, the question of what to do next is probably foremost in their minds. Surgery? Radiation? Wait to see how quickly the tumor grows? But somewhere in the midst of all the soul-searching, many inevitably wonder, Is there anything I could have done to prevent prostate cancer in the first place?

In 1993, a group of researchers embarked on the first large-scale, population-based study to try to find an answer. Nearly 19,000 men, ages 55 and older, enrolled in a seven-year landmark study, dubbed the Prostate Cancer Prevention Trial , to determine whether the drug finasteride could prevent prostate cancer. The choice of finasteride, typically prescribed for the relief of urinary symptoms associated with an enlarged prostate, was based on two observations:

  • Male hormones, or androgens, drive the development of prostate cancer. Two common androgens are testosterone and the more powerful dihydrotestosterone .
  • Men deficient in an enzyme called 5-alpha-reductase type 2 dont develop an enlarged prostate or prostate cancer. Without 5-alpha-reductase type 2, testosterone cant be converted into DHT, which promotes prostate growth.
  • Because finasteride tamps down 5-alpha-reductase type 2, researchers hypothesized that it would lower DHT levels and help prevent prostate cancer.

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    Common Side Effects Of Finasteride

    Like other FDA-approved medications, finasteride was put through a thorough testing process before it went on sale.;

    Because of this, lots of data is available about its potential side effects, risks and interactions.

    When looking into the side effects of finasteride, its important to be aware that two versions of finasteride are available.

    The first is Propecia®, the form of finasteride thats used to treat hair loss. This is available in a 1mg dosage and is designed for use once per day.

    The second is Proscar®, a high-strength version of finasteride thats prescribed to treat benign prostatic hyperplasia, or BPH.;

    This medication contains 5mg of finasteride per tablet. Due to its higher dosage, its more likely to cause certain side effects.

    Common side effects of 1mg finasteride include:

    • Erectile dysfunction . In clinical trials, approximately 1.3 percent of men who used finasteride experienced erectile dysfunction, compared to 0.7 percent of men who took a non-therapeutic placebo.

    • . This was reported by 1.8 percent of men who took finasteride and 1.3 percent of men who were given a non-therapeutic placebo.

    • Ejaculation disorder. In total, 1.2 percent of men who used finasteride reported issues related to ejaculation, with 0.8 percent reporting a lower semen volume. In comparison, 0.4 percent of men who used a placebo treatment reported lower semen volume.

    These side effects are much more common in men who use the 5mg version of finasteride as a treatment for BPH.;

    The Damaging Side Effects Of Finasteride

    A recent study has sent shock waves through the medical community.

    Concerns about a popular drug used by millions of men have revealed a growing number of disturbing side effects.

    The study is still under active research, but it suggests that finasteride a popular drug for treating prostate symptoms and male pattern hair loss causes alterations in the section of the brain responsible for processing long-term memory and emotional responses.

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    Does Finasteride Cause Prostate Cancer

    Prostate cancer is the most common cancer among men in Canada and the United States. Since finasteride lowers DHT a naturally occurring hormone that causes prostate growth researchers have wanted to examine whether finasteride could actually lower incidences of prostate cancer in men. Thus, the Prostate Cancer Prevention Trial study was created, involving more than 18,000 men over a period of nine years.

    The study found that finasteride lowered the risk of developing prostate cancer among men by 30 percent, which, just like reduced hair loss, can be considered a good thing. So whats the problem?

    It turns out that, despite the lower risk of developing prostate cancer, men in the study who took finasteride were at a higher risk of developing more serious forms of prostate cancer. That is, higher-grade prostate cancer whose cells spread faster and can be more aggressive. Although, more recent studies show that instances of high-grade prostate cancer causing death in the finasteride group versus the control group were minimal.

    Can Finasteride Cause Sexual Dysfunction

    The 4 Types of Prostate Cancer Treatment | Prostate Cancer Staging Guide

    British Columbias Health Authority lists two potential side effects of finasteride use related to mens sexual health. These include a decrease in sex drive and a decrease in the amount of semen discharged during orgasm. Neither effect is immediately dangerous to ones physical health, but they can persist even after patients have stopped taking finasteride.

    In the United States, the Food and Drug Administration announced changes to the professional labels that appear on both the 1mg and 5mg varieties of finasteride. These changes, announced in 2012, forced labels to include a list of sexual adverse effects that included erectile dysfunction, lower libido, ejaculation and orgasm disorders.

    This is understandably concerning to some men, given the importance of a healthy sex life to a mans overall wellbeing. Whats even more noteworthy is the persistence of side effects even if the drug is no longer being taken.

    With that said, the FDA acknowledges that only a small percentage of men experience these adverse effects. In clinical trials, just 3.8 percent reported they experienced one or more of the adverse sexual effects listed above. In those same trials, 2.1% of men who received a placebo also reported adverse sexual experiences. And for the most part, side effects stopped when the drug was no longer being taken.

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    Warning Labels Not Enough

    As a result of the latest Finasteride scandal, we reached out to prostate health expert and metabolic disease specialist Ben Ong for a breakdown of the latest research, and what other options men facing prostate disease have:

    As far back as 2008, European countries have been demanding updated warning labels on finasteride. But even they didnt know the side effects were permanent.

    The FDA only caved to pressure and put on those warning labels in 2012. But they didnt say anything about ED, loss of libido or performance issues being permanent.

    Talk on the inside is that the FDA might be considering recalling Finasteride depending on how the lawsuits play out.

    The further development of Post-Finasteride Syndrome is greatly disturbing, and the dangerous effect and the tragic consequences in regard to mens mental health should not be underestimated..

    What Is Finasteride And How Does It Work

    Finasteride has been traditionally used to treat an enlarged prostate. The prostate is a gland that is only present in the male anatomy. It produces the white fluid which carries the sperm when ejaculating. As men get older, the prostate grows in size, which is part of the natural ageing process. An enlarged prostate can increase the pressure placed on the bladder, which can cause symptoms such as the need to pass urine on frequent basis, difficulty urinating and difficulty emptying the bladder. Testosterone, a male hormone, is converted to Dihydrotestosterone within the prostate, causing it to grow in size. This reaction happens only in the presence of an enzyme known as 5-alpha reductase. If you block 5-alpha reductase, then testosterone does not convert to DHT, and the prostate does not increase in size; and this is what finasteride does. It is known as a 5-alpha reductase inhibitor, which means it blocks the action of 5-alpha reductase, so that testosterone does not convert to DHT, which means that the prostate will not grow.

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    Finasteride Side Effects Guide

    Medically reviewed by Kristin Hall, FNP

    Finasteride is one of the most popular and effective medications for men looking to prevent hair loss. Its also one of the few androgenetic alopecia treatments that has been approved by the FDA.;

    Its easy to see why. Used on its own, finasteride has been shown to stop hair loss and improve hair growth in the majority of men, often within three to four months.

    Finasteride comes in tablet form and is designed for use one time per day. Its easy to use and, under the supervision of a healthcare professional, can stop male pattern baldness in its tracks without the need for costly cosmetic procedures.

    But does finasteride come with a risk of side effects? The short answer is, well, yes. Like other medications, finasteride can cause side effects.;

    However, theres a lot of misinformation about finasteride and its potential side effects out there.

    In general, the risk of side effects from finasteride is low. Research shows that the majority of men who use finasteride over the long term benefit from a successful hair loss treatment with few or no undesired results.

    With this said, if youre considering using finasteride, or if youre already taking it, its important to understand what to expect.

    Below, weve listed the common and uncommon side effects you may experience while taking finasteride for hair loss.;

    Weve also talked about what you can do to reduce your risks of developing side effects while using finasteride.

    Take The Good With The Bad

    (PDF) Finasteride Does Not Increase the Risk of High

    While serious side effects may only impact a small number of finasteride users, its important to be aware of all the risks. This article only highlighted two of the potential side effects. There are more side effects to be aware of, and much more knowledge to be shared on the topic by a trusted healthcare professional.

    If youre considering all options for treating male-pattern baldness, schedule an appointment with a doctor. They will be able to assess your current health and any medication youre taking and decide the best course of action.

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    How To Shrink Your Prostate Without Finasteride Or Deadly Side Effects

    To help men who have prostate disease or are concerned about their prostate health, we are offering readers exclusive limited-time access to one of Bens special video presentations.

    Normally reserved for private clients, we highly recommend that you watch this video while you still can. Especially if you have a prostate disease, BPH, a high PSA, if you are a man over 50, or anyone who even knows a man over 50.

    • 5 deadly side effects of prostate drugs and why your doctor didnt tell you about them
    • How and why Flomax & Finasteride are doing you more harm than good
    • How you can improve your prostate health, side-effect-free, without using dangerous drugs and toxic treatments.

    For more information on prostate cancer medication click here.

    Effect Of Differential Biopsy Sensitivity On Disease Prevalence

    The first two analyses addressed biases related to imperfect ascertainment of biopsy end points on all study participants and differentially inaccurate grading of disease severity by biopsy between the treatment arms. The first analysis accounted for biases related to missing end points to estimate the overall prevalence of biopsy-detectable prostate cancer and high-grade cancer. The second analysis accounted for biases related to more accurate grading of high-grade disease with finasteride to estimate the prevalence of true high-grade cancer among participants with biopsy-detectable prostate cancer.

    All of the analyses presented include weights that are a function of measured covariates. Because the weights are estimated, their inclusion affects the variability of overall prevalence and risk estimates. To account for estimation of the weights, 10,000 bootstrap samples of the observed data were constructed. The analysis procedures were repeated on each data set and the variance of the prevalence estimates was estimated by the variance over all samples. All analyses were done in Splus .

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    Less Common Finasteride Side Effects

    Finasteride may also cause other, less common side effects. These include depression, pain in the testicles, changes in the breasts , itching, rash, hives, facial swelling and difficulty breathing or swallowing.;

    If you are experiencing any of these side effects you should immediately report this to a healthcare provider as they can indicate a severe allergic reaction that may be life threatening.

    Some of these side effects may be more common if you take finasteride at a higher dosage than the 1mg per day thats typically prescribed to treat hair loss

    If you experience any of these side effects while youre taking finasteride, its important to talk to your healthcare provider as soon as possible.

    What Are The Important Side Effects Of Propecia

    Recognizing Prostatitis vs Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

    The most common side effects associated with finasteride are:

    • breast enlargement,
    • ejaculation disorders.

    Serious side effects include increased risk of high-grade prostate cancer, and increased risk for male breast cancer.

    Propecia was approved by the FDA for the treatment of male pattern baldness in December 1997. Another finasteride oral dosage form, Proscar or 5 mg finasteride tablets are FDA approved only for the treatment of benign prostatic hyperplasia and should not be used for androgenetic alopecia. Do not confuse these finasteride tablets.

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