Baldness drug can skew prostate cancer test

By Jia-Rui Chong, Times Staff Writer

December 5, 2006

The hair-loss drug Propecia interferes with the most commonly used test
for prostate cancer, causing inaccurate readings that can mask the
presence of the disease, researchers reported Monday.

About 4 million men worldwide use the
drug, whose active ingredient is finasteride, which prevents the
breakdown of testosterone. Researchers knew that the high doses of
finasteride in Proscar, the drug used to treat an enlarged prostate,
could reduce levels of the marker called prostate specific antigen, or
PSA. The new study is the first to show that the lower levels in
Propecia also lower PSA levels.

The suppression could mean that a previously safe reading on a PSA test
could be false, said Dr. David Quinn, an oncologist at USC who has
worked on previous studies on finasteride and spoken for the drug's
maker, Merck & Co., on other drugs, but was not involved with this
study.

"If people are taking Propecia, they should know the PSA may not be the
most accurate predictor of cancer," he said. "Other tests, such as the
digital rectal exam, where the doctor is feeling the prostate, may be of
more importance."
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The study, published in the Lancet Oncology, followed 308 men age 40 to
60 with male-pattern baldness. The data were collected by Dr. Claus
Roehrborn, a urologist at the University of Texas Southwestern Medical
Center while he worked with Merck on developing the drug. Merck funded
the study.
For 12 months, 247 men took 1 milligram of finasteride daily, while 61
took a placebo.

In men taking Propecia, PSA readings steadily declined. Compared with
the beginning of the study, the readings at the end were a median of 48%
lower. The effect was slightly greater on men in the 50 to 60 age group.

"Doctors often tell men that their PSA is 'normal,' but don't tell them
what the number is," he said. "They should always know what the number
is."

Roehrborn said other drugs in this class, known as 5-alpha reductase
inhibitors, will affect PSA tests in a similar way.

Prostate cancer is the most commonly diagnosed cancer in men, with about
230,000 new cases expected in 2006, according to the American Cancer
Society.
*
jia-rui.chong@latimes.com

knowledge is power - growing old is mandatory - growing wise is optional
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

i believe saw palmetto has the same problem (it masks the psa).
a year ago my psa was 2.5 while on saw palmetto for years. i stopped
taking the saw palmetto and after 1 yr my psa jumped to 5.7. i was
then scheduled for a biopsy. i started the saw palmetto again and
tested my psa 2 mths after the biopsy. it went back to 2.5. what a
coincidence. it probably almost killed me. my surgeon told me after
the RLRP that i caught my cancer just in time. it penetrated the
capsule but my margins were negative. i just got my follow up psa
results today and it is 0.015.
it makes me sick when i think of all those poor men that are being
deceived that have cancer and don't know it.
the article i read was inconspicuous in the los angeles times. it
should have been on the front page. i am going to spread the word to
my friends and the vitamin stores i go to.
gary

c palmer wrote:
> By Jia-Rui Chong, Times Staff Writer
>
> December 5, 2006
>
> The hair-loss drug Propecia interferes with the most commonly used test
> for prostate cancer, causing inaccurate readings that can mask the
> presence of the disease, researchers reported Monday.
>
> About 4 million men worldwide use the
> drug, whose active ingredient is finasteride, which prevents the
> breakdown of testosterone. Researchers knew that the high doses of
> finasteride in Proscar, the drug used to treat an enlarged prostate,
> could reduce levels of the marker called prostate specific antigen, or
> PSA. The new study is the first to show that the lower levels in
> Propecia also lower PSA levels.
>
> The suppression could mean that a previously safe reading on a PSA test
> could be false, said Dr. David Quinn, an oncologist at USC who has
> worked on previous studies on finasteride and spoken for the drug's
> maker, Merck & Co., on other drugs, but was not involved with this
> study.
>
> "If people are taking Propecia, they should know the PSA may not be the
> most accurate predictor of cancer," he said. "Other tests, such as the
> digital rectal exam, where the doctor is feeling the prostate, may be of
> more importance."
> advertisement
>
> The study, published in the Lancet Oncology, followed 308 men age 40 to
> 60 with male-pattern baldness. The data were collected by Dr. Claus
> Roehrborn, a urologist at the University of Texas Southwestern Medical
> Center while he worked with Merck on developing the drug. Merck funded
> the study.
> For 12 months, 247 men took 1 milligram of finasteride daily, while 61
> took a placebo.
>
> In men taking Propecia, PSA readings steadily declined. Compared with
> the beginning of the study, the readings at the end were a median of 48%
> lower. The effect was slightly greater on men in the 50 to 60 age group.
>
> "Doctors often tell men that their PSA is 'normal,' but don't tell them
> what the number is," he said. "They should always know what the number
> is."
>
> Roehrborn said other drugs in this class, known as 5-alpha reductase
> inhibitors, will affect PSA tests in a similar way.
>
> Prostate cancer is the most commonly diagnosed cancer in men, with about
> 230,000 new cases expected in 2006, according to the American Cancer
> Society.
> *
> jia-rui.chong@latimes.com
>
> knowledge is power - growing old is mandatory - growing wise is optional
> "Many more men die with prostate cancer than of it. Growing old is
> invariably fatal. Prostate cancer is only sometimes so."
> http://community.webtv.net/PALMER_ENT/doc

I had been on Proscar 5mg for years to control my bph, was advised by
urologist to always double the psa lab result to get an accurate
reading. Eventually my pca was diagnosed because of a velocity change in
psa between two readings, which was subsequently confirmed by biopsy.

"From Bob" <IATROGENIC@webtv.net> wrote in message
news:12866-45766DEB-906@storefull-3313.bay.webtv.net...
>I had been on Proscar 5mg for years to control my bph, was advised by
> urologist to always double the psa lab result to get an accurate
> reading. Eventually my pca was diagnosed because of a velocity change in
> psa between two readings, which was subsequently confirmed by biopsy.

In 1999 I was on Proscar for BPH. I read that it could lower PSA scores.
My internist had no knowledge of that. This was the same internist who was
not alarmed at my increasing PSA counts. Kept saying my final count was
normal for my age. I insisted on a free PSA test. He called to tell me
results were normal....he quoted some numbers which were not the % number
that I understood. Foolishly I didnt pursue it any further. On my next PSA
test (still "normal" according to him), I looked at the paper he was holding
and saw that my free PSA was 15%. I yelped. He said, "What are you worried
about? Look how *low* it is." I insisted on a biopsy by a urologist.
Cancer. RP in 2002. So far, so good. But this internist could have cost
me my life. He was not too young or too old. Early 50's.

Lesson: Don't assume your internist knows even as much as you do about PCa.
Any PCa concerns---Deal with a urologist.

(Yes, I do have a new internist now. He's a young guy who is very quick to
refer.)

"c palmer" <PALMER_ENT@webtv.net> wrote in message
news:16356-45753F55-1004@storefull-3212.bay.webtv.net...
> By Jia-Rui Chong, Times Staff Writer
>
> December 5, 2006
>
> The hair-loss drug Propecia interferes with the most commonly used test
> for prostate cancer, causing inaccurate readings that can mask the
> presence of the disease, researchers reported Monday.

Conversely, I am growing more hair since adding Casodex to my diet. Go
figure.




--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
PSA <0.04
Non Illegitimi Carborundum