Hair Transplant | Finasteride - Prostate Cancer – Hair Loss?

Finasteride - Prostate Cancer – Hair Loss?

Finasteride, is a 5-alpha reductase inhibitor that prevents the conversion of testosterone to dihydrotestosterone (DHT). In the 5-mg dose, it has been used for the treatment of non-cancerous prostate tumors and in the 1-mg dose has been prescribed both as a prevention and treatment for early onset male pattern baldness. However, some caution was taken when a study conducted in 2003 by the National Cancer Institute suggested that while Finasteride 5mg (Proscar) might be responsible for a 25% reduction in the overall incidence of prostate cancer, it might also be responsible for an increase of 25.5% in high-grade, aggressive tumors detected in these patients when compared to the placebo group. This random study was conducted on a group of 18,000 men.

The 2003 study, however, did not conclude whether the increased incidence of high-grade tumors was caused by finasteride or if finasteride, in fact, aided in the detection of pre-existing high grade aggressive cells.

Finasteride, is a 5-alpha reductase inhibitor that prevents the conversion of testosterone to dihydrotestosterone (DHT). In the 5-mg dose, it has been used for the treatment of non-cancerous prostate tumors and in the 1-mg dose has been prescribed both as a prevention and treatment for early onset male pattern baldness. However, some caution was taken when a study conducted in 2003 by the National Cancer Institute suggested that while Finasteride 5mg (Proscar) might be responsible for a 25% reduction in the overall incidence of prostate cancer, it might also be responsible for an increase of 25.5% in high-grade, aggressive tumors detected in these patients when compared to the placebo group. This random study was conducted on a group of 18,000 men.

The 2003 study, however, did not conclude whether the increased incidence of high-grade tumors was caused by finasteride or if finasteride, in fact, aided in the detection of pre-existing high grade aggressive cells. Two recent adjunct studies, one by Dr. Yael Cohen of Gamida Cell in Jerusalem and the other Dr. M. Scott Lucia of the University of Colorado Health Sciences Center shed some light on this question. Both studies looked at the increased incidence of high-grade tumors and reached a somewhat different conclusion than the original study.

In one study they found that finasteride does not increase the occurrence of high grade, aggressive tumors, but, in fact aids in detecting them. The reason is that Finasteride reduces the volume of the prostate so there is less non-cancerous tissue present. Therefore, it is more likely that during a needle biopsy, the more high-grade cancerous tumors would be detected.

The other study analyzed the surgically removed prostates of cancer patients and found that the previously described increase in high-grade tumors in the finasteride group was, in fact, less than the original researchers had believed.

Further research needs to be done, but these studies support the safety of using finasteride 5mg in patients with BPH (prostate enlargement). It can be reasonably assumed that the lower 1mg dose used for hair loss would be safe as well.

Robert Bernstein, MD
Member, International Alliance of Hair Restoration Surgeons