Propecia and PCa
JK
years with great results but..... why do they have a warning for guys with
PCa? Does it increase hormone levels?
--
JK Sinrod
www.MyConeyIslandMemories.com
tarho...@carolina.rr.com
JK:
Good question. Propecia is a formulation of a drug called Proscar and
this drug has an effect of reducing the amount of dihydrotestosterone
in the body. DHT is a metabolite of Testosterone. Without affecting
the circulating testosterone, this drug reduces the powerful component
DHT and thus counfounds a prostate PSA test. With DHT, a prostate
cancer, if present, may grow larger or faster, and by using Propecia,
the reduction of DHT my mask a PSA that would otherwise appear
suspicious. Many people simply double their PSA scores if they take
this drug. ALWAYS, tell your urologist if you are on this drug for any
reason, even if it is the over the counter type found in the hair
growth compounds.
Alex
<tarho...@carolina.rr.com> wrote in message
news:e2919d88-1f1d-4dc6...@y5g2000hsf.googlegroups.com...
> On Jan 24, 12:00 am, "JK" <jksinrod*SP...@aol.com> wrote:
>> I have a 29 year old son that's been taking this hair growth stuff for
>> 2
>> years with great results but..... why do they have a warning for guys
>> with
>> PCa? Does it increase hormone levels?
>> --
>> JK Sinrodwww.MyConeyIslandMemories.com
>
> this drug has an effect of reducing the amount of dihydrotestosterone
> in the body. DHT is a metabolite of Testosterone. Without affecting
> the circulating testosterone, this drug reduces the powerful component
> DHT and thus counfounds a prostate PSA test. With DHT, a prostate
> cancer, if present, may grow larger or faster, and by using Propecia,
> the reduction of DHT my mask a PSA that would otherwise appear
> suspicious. Many people simply double their PSA scores if they take
> this drug. ALWAYS, tell your urologist if you are on this drug for any
> reason, even if it is the over the counter type found in the hair
> growth compounds.
The above information is entirely correct. But one sentence could be
misunderstood by a casual reader. It says, "With DHT, a prostate cancer, if
present, may grow larger or faster..."
I believe that what the poster is saying is that if PCa is present, the
Proscar could mask an upturn in PSA.
But the sentence could be misconstrued to mean that Proscar could CAUSE the
PCa to grow larger or faster. That, of course, is not the case. Yes, Proscar
suppresses PSA readings. But no, Proscar does NOT cause any acceleration in
cancer growth.
(Proscar can also cause a large prostate gland to shrink in size -- mine is
now about 40% smaller than before I started taking Proscar about eight
months ago.)
Alex
e...@math.uchicago.edu
wrote:
> Proscar could mask an upturn in PSA.
> But the sentence could be misconstrued to mean that Proscar could CAUSE the
> PCa to grow larger or faster. That, of course, is not the case. Yes, Proscar
> suppresses PSA readings. But no, Proscar does NOT cause any acceleration in
> cancer growth.
Alex,
Actually, if you check out the results of the PCPT, the men taking
Proscar had a higher percentage of high-Gleason score PCa then those
not taking it. There have been a number of explanations put forth
about thus, ranging from you can't trust the Gleason score to be
accurate when using Proscar to DHT being converted to a chemical that
slows PCa growth.
My own model predicts that this increase is due to men taking
phytoestrogens (such as soy) in conjunction with Proscar. The
phytoestrogens generally have anti-cancer effects, but also increase
the production of bcl-2, a protein that protects PCa from apoptosis.
In general, they are more helpful than harmful. However, Proscar also
increases bcl-2 while increasing some apoptotic proteins as well. In
general, this is a good thing, however, when you combine Proscar with
phytoestrogens, then they are both increasing bcl-2 and you run the
risk of raising the bcl-2 level to above a critical threshhold. Dr.
Leibowitz has actually observed that his patients taking Proscar had
sharp increases in their PSA when taking phytoestrogens, which was
reversed when they stopped taking them.
Ed Friedman
I.P. Freely
> My own model predicts that this increase is due to men taking
> phytoestrogens (such as soy) in conjunction with Proscar. The
> phytoestrogens generally have anti-cancer effects, but also increase
> the production of bcl-2, a protein that protects PCa from apoptosis.
> In general, they are more helpful than harmful.
Ed, I consume very little soy in other products, but my favorite Vidalia
onion salad dressing is based on soybean oil. I eat something like 80
gms/month of soybean oil in that. Would you advise I cut back on or stop
that altogether?
I.P.
e...@math.uchicago.edu
> Ed, I consume very little soy in other products, but my favorite Vidalia
> onion salad dressing is based on soybean oil. I eat something like 80
> gms/month of soybean oil in that. Would you advise I cut back on or stop
> that altogether?
>
> I.P.
I.P.,
I wouldn't worry about taking soybean oil unless your bcl-2 levels are
already very high. If you are taking Proscar of Avodart, then you
should avoid all soy. Another possible reason to avoid soy would be
if you had a Gleason 9 or 10 score. The more aggressive PCa's have
slower rates of apoptosis. In many cases, this is due to too much
bcl-2, but in some cases due to some other mutation. Since you don't
know which is the case, to be safe it would be best to avoid soy for
those men.
However, if you don't already have high levels of bcl-2, then the use
of soy should be benificial. Numerous studies have demonstrated its
anti-cancer properties. The problem for men with PCa is that you
don't know how much above or below average your bcl-2 levels are in
your cancer cells, and even if you did know, the population is
heterogeneous so there most likely will be some cells that thrive on
the soy.
To summarize, for all practical purposes, moderate amounts of soy
should do little or no harm and may do some good. Massive amounts may
kill some more cancer cells, but may spur the growth of others. The
only exceptions to this is if you are taking 5AR2 inhibitors or are
known to have extremely aggressive PCa cells in you.
Ed Friedman
I.P. Freely
> To summarize, for all practical purposes, moderate amounts of soy
> should do little or no harm and may do some good. Massive amounts may
> kill some more cancer cells, but may spur the growth of others. The
> only exceptions to this is if you are taking 5AR2 inhibitors or are
> known to have extremely aggressive PCa cells in you.
No meds, but my cancer was Gleason 4+4=8 with PSA = 8.8 and PSAV > 2.0
at surgery. SVI, neg margins, N=0, cTNM = 1. Lots of Gleason 4 in
several cores, but no 5, as per Bostwick. Quarterly PSA since RP three
years ago all at or below 0.030, mostly below 0.015. No drugs
anticipated within several years.
Sounds like I may be on the cusp of soy benefit/harm. Your best guess on
whether to avoid soy?
I get the impression that unless they assayed my bcl-2 level at the time
of my RP pathology, we cannot determine its level. If so, it sounds like
I really should let the wife eat the rest of our new case of dressing
and find myself a new favorite dressing.
Or -- IhopeIhopeIhope -- my 4+4 and no drugs gives me a pass.
OTOH, my last three PSAs were 0.006, 0.015, and 0.030. Supersensitive
noise, we hope, but no guarantees.
I.P.
Steve Kramer
> OTOH, my last three PSAs were 0.006, 0.015, and 0.030. Supersensitive
> noise, we hope, but no guarantees.
Well, like you've said, I.P., your PSA has been as low as 0.006 twice and in
between those two occasions you had PSAs with an almost identical track --
0.006, 0.012, 0.030 as I recall. It's all under the gold standard
(suddenly, I love using that phrase) of 0.10 and would be of no interest if
you didn't have the hyper sensitive testing.
--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04 10/11/07
Non Illegitimi Carborundum
I.P. Freely
> "I.P. Freely" <fuhghed...@noway.nohow> wrote in message
>
>> OTOH, my last three PSAs were 0.006, 0.015, and 0.030. Supersensitive
>> noise, we hope, but no guarantees.
>
> Well, like you've said, I.P., your PSA has been as low as 0.006 twice and in
> between those two occasions you had PSAs with an almost identical track --
> 0.006, 0.012, 0.030 as I recall. It's all under the gold standard
> (suddenly, I love using that phrase) of 0.10 and would be of no interest if
> you didn't have the hyper sensitive testing.
100% agree.
It's what the VA provides, free, whenever I want it, and I'm far more
anxious over that TV writers' strike thingie than over my PSA, and I'll
hit 0.2 or 1.0 or whatever at the same pace no matter how many decimal
places they tack on, so I let 'em have their fun. ;-)
OTOH, anecdotal or not, I'd guess my docs would find it interesting --
maybe not USEFUL, but still interesting -- if this three-decimal stuff
actually, clearly, and accurately predicted a textbook biochemical
relapse a year in advance.
I suspect if it hits 0.060 next month (quarter) some eyebrows --
including mine -- will go up.
I.P.
Alex
<e...@math.uchicago.edu> wrote in message
news:19fa5241-57a4-4f13...@q77g2000hsh.googlegroups.com...
Ed -- Thanks for this information. It's something I was not aware of.
[This kind of analysis is why we pay you the big bucks! (g)]
My doc and I have been talking about me having another biopsy. It will be
interesting (!) to see if the Gleason score has changed with Proscar.
Alex