| Proscar is drug prescribed
to men to treat one of the illnesses of old age, benign prostatic hyperplasia.
Many men experience a non-cancerous enlargement of their prostate gland.
Since the prostate is right above the urethra, when it becomes larger
it squeezes it and obstructs the flow of urine from the bladder. The problems
associated with it are in the difficulty to urinate and the need to do
it urgently and frequently. The disease is progressive, which means that
if left untreated it can lead to serious complications and urinary tract
infections. Proscar works by lowering the level of the hormone DHT which
plays a key role in prostate enlargement. This causes the gland to shrink
back and gradual improvement in ability to urinate. The DHT hormone is
also responsible for balding head in men, so administering Proscar can
either prevent hair loss, or even treat it with hair starting to grow
on bald stops. The only disadvantage of the medicine seems to be its anti-aphrodisiac
action, because it has been reported that it causes decreased potency.
MMW Fortschr Med. 2003 Jun 12;145(24):40-2.
Hormone therapy, chemotherapy and immunotherapy in breast carcinoma.
The best strategy for your patient
Sayer HG, Hoffken K.
Klinik und Poliklinik fur Innere Medizin II (Onkologie, Hamatologie, Endokrinologie
und Stoffwechselerkrankungen), Friedrich-Schiller-Universitat Jena.
Modern treatment of cancer of the breast is based on established prognostic
factors (patient age, receptor status, tumor size, lymph node involvement,
tumor grading), and thus takes the patient's individual risk profile into
account. In addition to the antiestrogen, tamoxifen, new hormonal preparations,
such as the aromatase inhibitors, hold out promise of improved results
from adjuvant treatment in elderly women. In premenopausal women, additional
hormone blockade by means of GnRH analogs is of advantage. Neoadjuvant
(preoperative) chemotherapy protocols will enable rapid evaluation of
new therapeutic options. When metastases have developed, treatment with
hormonal drugs is indicated in the case of slowly progressing disease
(low risk), while clinically progressive metastasization (high risk) requires
cytostatic chemotherapy. Here, studies involving more recent substances
with improved tolerability, and tumor-specific antibodies, confirm an
improvement in the prognosis. The concentration of drug treatment in interdisciplinary
centers is a necessary element of quality assurance and therapeutic optimization.
Urology. 2003 Nov;62(5):894-9.
Roehrborn CG, Lee M, Meehan A, Waldstreicher J; PLESS Study Group.
University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110,
USA
Effects of finasteride on serum testosterone and body mass index in
men with benign prostatic hyperplasia.
To examine the effect of finasteride on serum testosterone in men with
benign prostatic hyperplasia (BPH). The Proscar Long-Term Efficacy and
Safety Study (PLESS) was a 4-year trial comparing the safety and efficacy
of finasteride 5 mg with placebo in 3040 men with moderate to severe symptomatic
BPH and enlarged prostates. PLESS included the prospective measurement
of annual serum testosterone in a randomly selected subset of patients
comprising approximately 10% of the randomized population (n = 301). Finasteride
treatment led to a modest, but significant (P <0.001), increase relative
to placebo in serum testosterone, with this increase greatest in patients
who had low baseline testosterone levels. The larger testosterone increases
seen in finasteride-treated patients in the lower baseline testosterone
tertiles were associated with significant mean reductions relative to
placebo at year 4 in body mass index (BMI), ranging from 0.6 to 0.8 kg/m2.
No statistically significant between-group difference was found in BMI
in the upper testosterone tertile. The sexual adverse experience profiles
for finasteride and placebo were similar across the baseline testosterone
cohorts examined. Finasteride treatment led to a generally modest increase
relative to placebo in serum testosterone, with the greatest increases
occurring in men with low baseline testosterone levels. The physiologic
significance of these changes in men with low baseline testosterone levels
is unclear, but the associated reduction in BMI is intriguing and may
be related, because BMI is known to be negatively correlated with serum
testosterone levels in men.
Urology. 2003 Nov;62(5):872-6.
Barqawi AB, Moul JW, Ziada A, Handel L, Crawford ED.
Division of Urology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA.
Combination of low-dose flutamide and finasteride for PSA-only recurrent
prostate cancer after primary therapy.
To evaluate the efficacy and tolerability of combined finasteride and
low-dose flutamide for prostate-specific antigen (PSA)-only recurrence
after definitive therapy and to determine the predictors of recurrence-free
survival. Seventy-one men with biochemical recurrence after primary therapy
for prostate cancer were prospectively enrolled from 1996 to 1998. Forty-two
patients had undergone radical retropubic prostatectomy and 29 had undergone
external beam radiotherapy. Radionuclide bone scans and computed tomography
of the abdomen and pelvis showed no metastasis. The initial treatment
with finasteride (5 mg twice daily) and flutamide (125 mg twice daily)
was continued unless participants were unable to tolerate the agents or
experienced PSA progression. At a mean of 44.4 months (range 12 to 92)
of follow-up, 54 (76%) of 71 patients were available for measurement of
disease status and response to therapy. Three patients had died of unrelated
causes; 5 men withdrew from the study because of side effects and 1 patient
for protocol violation. Eight patients were lost to follow-up. Twenty-seven
patients (38%) continued receiving therapy with no evidence of PSA progression
(PSA level less than 0.4 ng/mL), 6 patients maintained a more than 50%
reduction in their baseline PSA level at the time of analysis, and 21
(29%) had PSA progression (ie, elevated PSA level on three consecutive
tests more than 4 weeks apart). Major side effects were breast tenderness
(90%), gynecomastia (72%), gastrointestinal disturbances (22%), fatigue
(10%), and decreased libido (4%). The side effects were mild and well
tolerated by most patients. The combination of finasteride and flutamide
showed a moderate efficacy in patients with PSA-only recurrence after
definitive therapy. The efficacy appears to be greater in patients who
can achieve a PSA nadir of 0.1 ng/mL or less after the start of treatment.
J Investig Dermatol Symp Proc. 2003 Jun;8(1):20-3.
Shapiro J, Kaufman KD.
Division of Dermatology, University of British Columbia, Vancouver General
Hospital, Vancouver, British Columbia, Canada.
Use of finasteride in the treatment of men with androgenetic alopecia
(male pattern hair loss).
Finasteride, a type 2-selective 5alpha-reductase inhibitor, was approved
in 1997 as the first oral pharmacologic therapy for the treatment of men
with androgenetic alopecia (AGA; male pattern hair loss). Originally developed
for the treatment of men with benign prostatic hyperplasia (BPH) at a
dose of 5 mg/day, finasteride has a well-established, excellent safety
profile. Subsequent studies demonstrated that finasteride was an effective
treatment for men with AGA at an optimal dose of 1 mg/day. This report
summarizes the published peer-reviewed literature on the use of finasteride
in the treatment of men with AGA, including the data on long-term (5 years)
use of finasteride in a placebo-controlled clinical trial environment.
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Finasteride
(proscar)
