Propecia has always been top of the class as far as treatment for hair loss is concerned but it’s copped some undeserving slack over the years, it would appear, concerning its relationship to prostate cancer. A comprehensive re-evaluation of the largest prostate cancer prevention study ever completed revealed that initial results underestimated the benefits and overestimated the potential risks of finasteride (Propecia’s key ingredient).
Initial results from the 18,822 participant Prostate Cancer Prevention Trial (PCPT) showed that men who took 5 mg of finasteride daily for seven years had a 25 percent reduced risk of developing prostate cancer compared with men taking a placebo. However, finasteride also seemed to be associated to the development of more aggressive prostate cancer in some men. Because of these findings which were published in 2003, few doctors have recommended finasteride for prostate cancer prevention and it has caused concern amongst some hair loss sufferers.
Neither conclusion now appears to be accurate, according to Dr. Ian Thompson, chair of the Department of Urology at the University of Texas Health Science Center at San Antonio and a senior author on both studies and lead author on the original PCPT.
A new analysis on the PCPT data using advanced statistical modeling techniques and a complete assessment of prostate tissue biopsies debunked previous concerns. It concluded that finasteride actually reduced the risk of developing prostate cancer more than researchers had originally thought, did not increase development of more aggressive cancers, and the majority of tumors that finasteride prevented were those that could spread and cause death.
“We’ve now shown that the cancers prevented by finasteride are often clinically significant, the same kind of cancers that lead to surgery,” Dr. Thompson says. “In addition, we showed a 28 percent reduction of high-grade cancer with finasteride.”
Researchers studied biopsies and prostate gland tissue that had been removed to see whether finasteride actually increased aggressive cancers in some men, and concluded that it did not.
“Finasteride actually shrank the prostate gland, so it appeared in initial studies that more cancer was being found in biopsies of men who took the drug,” said Mary Redman, Ph.D., a biostatistician at the Fred Hutchinson Cancer Research Center.
“What that means is that the cancer took up more prostate tissue in men who were treated, and that is why it was easier to find in a biopsy. Cancer was probably missed more often in biopsies of men on a placebo drug because the prostate gland itself was larger,” Redman said.
Redman also found there was no evidence that the drug increased the rate of aggressive tumors and likely decreased their rate by 27 percent.
These new findings suggest that men should take an “individualised” approach to prostate cancer prevention, Dr. Thompson said.
Researchers have known for years that the same testosterone metabolism responsible for prostate growth also causes male pattern hair loss. Both have to do with testosterone being converted to dihydrotestosterone (DHT) by the 5-alpha reductase enzyme. DHT, which is a more potent stimulator of prostate cell proliferation than testosterone, also activates the genes responsible for development of male pattern hair loss. Finasteride is a 5-alpha reductase inhibitor and therefore stops the conversion of testosterone to DHT.
Finasteride was initially developed in the 1990s for the treatment of benign prostatic hyperplasia (BHP), also known as enlarged prostate disease. The finasteride drug Proscar was first approved by the U.S. Food and Drug Administration for this use. In 1997, the FDA approved finasteride in the form of Propecia for the treatment of male pattern hair loss. While Propecia is administered at 1mg per day, patients who use Proscar get a five times higher dosage.
Dr. Elena Dimitrova of the Belgravia Centre recommends patients who are taking Propecia as part of their hair loss treatment course, to cease use for a week before taking a PSA test for a more accurate result.
“Propecia will stay in the body for seven days before it is eliminated via the kidneys,” Dr. Dimitrova said.
Propecia is a highly effective and accepted form of treatment for hair loss since its licensing from both the MHRA and FDA and patients of the Belgravia Centre have had tremendous results when combined with other treatments.
Minoxidil is the only other medically licensed hair loss treatment. This is able to be used by both men and women, whereas finasteride 1mg is strictly for men only. At The Belgravia Centre clinics a range of high strength minoxidil products are available and more information about these formulations is available by contacting the clinic directly.
If you’re concerned about hair loss but are feeling sceptical because of previous misconceptions regarding finasteride, book a free consultation with a specialist at the Belgravia Centre.
The Belgravia Centre
The Belgravia Centre is the leader in hair loss treatment in the UK, with two clinics based in Central London. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the UK or the rest of the world. View our Hair Loss Success Stories, which are the largest collection of such success stories in the world and demonstrate the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time for our hair loss helpline or to arrange a free consultation.