wondering about finasteride

maddog78

Hi all! I'm new to the board as I have been recently diagnosed with a gleason score of 3+3=6. I feel very blessed that it is such a low grade, and at this point have decided on active surveillance. My doctor also put me on Finasteride. I didn't think much of it at the time, but after doing some research, I'm questioning if I should be taking this. Everything I have seen it is prescibed before a cancer diagnosis and there is a risk of a higher grade cancer. I haven't really seen where someone already diagnosed with cancer is prescribed Finasteride. I plan on getting back with my doctor to discuss this, but wanted to educate myself a little first. Thanks to anyone who has any thoughts on this.

oldspice

Active surveillance is most likely the correct decision. I don’t know much about the drug prescribed but after researching it has much to do with BPH and enlarged prostates as well as lowering PSA levels. More drugs with side effects are always a challenge but this one can actually cause cancer. Do some research and trust your instincts

Clevelandguy

Hi,

Doctors and institutions say Finisteride can increase your risk of serious Prostate cancer. If it was me I do not think I would want to take it. If you have BPH I would look at other drugs that do not have a possible cancer side effect. Just my humble non medical opinion.

Dave 3+4

jc5549

There has been a lot of back and forth regarding Finasteride and its impact on Pca. The main reason to be taking the medication is for BPH symptoms especially if you have a moderate to large volume gland. I am attaching a good editorial comment in the New England J of Medicine that summarizes your question well.
Bottom line is why did your urologist put you on the med, if it was to prevent progression of disease I don’t know if there is scientific support to warrant that approach. If it is because you have significant urinary symptoms that respond well to this medication it seems there is no additional risk to being on the medication while also being on active surveillance.

jc

NEJM 2019 editorial Finasteride and Pca.pdf

Oldernow

Welcome maddog78 -

I was put on Finasteride way back in the late 90's to treat a greatly enlarged prostate. The Finasteride along with Flomax worked great to ease my difficult urinary issues. One aspect of Finasteride treatment that is often overlooked is that it causes your PSA results to be cut in half. In other words, when my PSA reached 10 it was actually 20. I am still taking both meds even following my radiation treatment for prostate cancer last year.

You can find my story at this link -

https://csn.cancer.org/discussion/327535/lupron-living-with-the-side-effects

I was told that the Finasteride could help prevent prostate cancer but if you did develop cancer it could be a higher grade. Thankfully that didn't happen. My cancer was a 3+4 with a Decipher score at the high end of intermediate for the chance of metastasis. My radiation oncologist wanted me to STOP the Finasteride to get a true reading of my PSA so he could put me in a research study he is part of. Two days after stopping the Finasteride I started having urinary retention symptoms. I restarted the Finasteride and the retention symptoms cleared quickly.

Following the radiation treatment and ADT (Lupron) last year my PSA has stayed undetectable at <.03 ng/mL. I guess I'll be taking both Finasteride and Flomax "forever" to keep from having urinary retention issues.

In short, the Finasteride really helped me with my BPH issues and continues to be necessary following radiation. I pretty much have normal urinary capabilities and am thankful for that…

Good luck on your journey maddog78 👍️

maddog78

https://csn.cancer.org/discussion/comment/1714751#Comment_1714751

Interesting article. Thanks..

VascodaGama

Hi, Maddog78

Finasteride is a 5-alpha redutacy inhibitor (5-ARI) that works by prohibiting the biosynthesis of testosterone into dihydrotestoste (a ten fold potent androgen). High levels of Dihydrotestoste has been associated to hyperplasia, therefore leading to recommend 5-ARI in BPH treatment.

This is also the stuff that some PCa cells like for an evening cocktail enjoyment. Oncologists typically recommend finasteride in hormonal treatments to block feeding the bandit. Surely, the aim starts with clinical castration (ADT) plus antiandrogens adding 5-ARI in a triple blockade.

In fact, the fast lowering of the PSA when taking finasteride may signify that those tiny buggers 🐛 are much influenced by the dihydrotestoste in circulation in our body.

If the PSA maintains the same profile in monthly tests and you have no hyperplasia or urination issues, then there is no reason to continue with fisasteride.

Best of lucks in your journey.

Vgama