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John, I am currently taking it and it has apparently worked as planned, i.e., it lowered my PSA in half in just 3 months. I have recurrent cancer with a very slow rise in PSA over the last 7 years and my uro suggested Finasteride and I balked at first until I did more research. I concluded that the reports that it caused aggressive cancer or masked the real PSA value were over ridden by subsequent data. I am a moderator for PCRI (Prostate Cancer Research Institute) and the info I gained from physicians there led me to start taking the drug and I plan to continue at this point. One set of data suggests the drug can slow progression for 2 years or longer. As always, everything we deal with seems to be a two headed coin and you have to "flip" the coin based on your individual beliefs in many cases.
Finasteride helps with male pattern baldness but not (unfortunately) with prostate cancer. They are both driven by testosterone derivatives, so there was a possible win-win scenario. But the clinical trials showed a reduction in low-risk prostate cancer but no reduction in men dying of prostate cancer. The other problem was side-effects - loss of libido breast enlargement etc. The drug is probably most useful for women going bald.
I do not agree with Peter. I believe there are good studies showing benefit for treating prostate cancer. I know of 4 leading Prostate Oncologist ( Shultz, Lebowitz, Meyers, Strum) that prescribe it. When you are on androgen deprivation why would you not want to suppress DHT? DHT is 10 times stronger than Testosterone.
John, as I mentioned, my PSA was cut in half in just 3 months while taking Finasteride and a leading oncologist thinks it will go even lower. So...if the psa is dropping and not rising, I do not understand how taking the drug is not beneficial. I have had zero side effects thus far.
I've been checking the literature for the past few hours. There have been a number of studies following finasteride as a potential prostate cancer preventative agent. It reduced PSA levels, reduced low-grade prostate cancers, but INCREASED high-risk prostate cancer. There is some controversy about whether or not it just increased the rate of finding the high risk cancers by shrinking the prostate. The biopsies may have had a higher chance of finding the high risk cancers. Or, the finasteride may have actually increased tumor progression.
There is not much data on using finasteride for treatment of recurring disease. It frequently reduces PSA levels in cases of "biochemical failure". It may have a role in management of metastatic disease but there is no good data to that effect yet. It is cheap, which is an advantage.
