Propecia, PSA Testing and Other Factors
Propecia, the first non-topical prescription treatment for androgenetic alopecia (male pattern baldness), works in 65% of men to prevent hair loss and re-grow hair. Studies conducted recently in
In a clinical study of Propecia (finasteride), independently conducted and published in Biology Digest, research showed that 26% of men between the ages of 18 and 49 using Propecia reported moderate to dense hair growth after for four months, while 33% had minimal re-growth. In the same group of men, further hair loss was significantly retarded by 78% with the use of Propecia. Over time, more than 75% of Propecia users reported growth, while 25% reported no further growth but no noticeable loss.
Two lessons are clear: starting Propecia early in life provides more long-term benefits, and starting Propecia before a significant amount of hair is lost (even when older) prevents further balding. Finally, starting early and staying on Propecia provides the most long-term benefits.
BPH and PSA Testing With Propecia
Though Propecia users experienced side effects, these were minimal (allergic reactions), or clinically insignificant (.2% had sexual side effects, declining to .03% at 5 years). The primary concern among researchers and doctors was the discovery that taking Propecia (finasteride) caused a decline in PSA testing results. PSA, or prostate-specific antigens produced by the prostate gland, are measured to determine the levels of a specific protein considered to be a prostate cancer marker. Among older men using Propecia, this decline averaged 50%, making test results inconclusive.
However, clinicians now admit that PSA testing lacks sensitivity. Some men with prostate cancer have normal PSAs. It is also highly nonspecific; almost 75% of men with an abnormal PSA did not have cancer. Researchers have tried enhancing the test with age specific cutoffs, velocity measurements, and density gradients. None of these have demonstrated any benefit in clinical practice.
Until recently, all BPH was considered to be a single disease, with a poor prognosis. More recently, researchers have identified a genetic marker (JM-27), which signals the most aggressive type of BPH, leading doctors and researchers to conclude that BPH, like cancer, may have both a benign and malignant aspect. Out came the prescription pads; Propecia was again given the go-ahead.
Other Tests for BPH and Prostate Cancer
More recently, a transrectal ultrasound-guided needle biopsy sampling has become a major weapon in diagnosis and monitoring of Prostatic Intraepithelial Neoplasia (PIN), or dysplasia, which can lead to cancer. Though considerably less comfortable, the test is more accurate than PSA. However, a positive result will necessitate yearly PSA testing, so be sure to tell your doctor if you are using Propecia.
Conclusions
The use of Propecia to retain or re-grow hair is not a significant factor in the failure of PSA testing where clinicians are advised of its use. In fact, Propecia users noted a reduction of BPH symptoms when using Propecia as directed (not surprising, since another use for the same drug – finasteride as Proscar – is actually used to treat BPH). If you want to give up anything, give up red meat and switch to soy, which has proven benefits in both BPH and prostate cancer. Keep your Propecia prescription to regain your hair and remain a healthier person.