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
Robert M. Bernstein, MD Robert M. Bernstein, M.D., is recognized world wide for his pioneering work in Follicular Unit Transplantation and Follicular Unit Extraction. His Center for Hair Restoration in Manhattan is devoted to the treatment of hair loss using these state-of-the-art techniques. Dr. Bernstein, Clinical Professor of Dermatology at Columbia University, is the recipient of the "Platinum Follicle Award” for "Outstanding Achievement" in scientific and clinical research in hair restoration. This is the highest honor awarded by the International Society of Hair Restoration Surgery. “Dr. Bernstein has contributed to the field of hair transplantation in dramatic and substantial ways, revolutionizing the advancement of Follicular Unit Hair Transplantation. His published articles have become ‘Bibles’ for this methodology. Dr. Bernstein has been chosen as one of “America’s Top Doctors,” by Castle Connolly Medical and New York Magazine's "The Best Doctors in New York” for nine consecutive years. He has been selected to be among New York Magazine’s “Best Beauty Docs in New York” for his pioneering work in Follicular Unit Transplantation and Follicular Unit Extraction. Dr. Bernstein's contributions to the field of hair transplantation and devotion to patient care have earned him the honor of "Pioneer of the Month" and "Surgeon of the Month" in Hair Transplant Forum International. Dr. Bernstein has been featured on Good Morning America, The Today Show and The Discovery Channel. He has appeared on The Early Show, CBS News, Fox News, and National Public Radio, and in GQ Magazine, Men’s Health and Vogue. Dr. Bernstein's is a member of the International Alliance of Hair Restoration Surgeons and recommended by the American Hair Loss Association. Visit Dr. Bernstein's Website: www.bernsteinmedical.com
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