More Aggressive Prostate Cancer While on Finasteride?

I’ve seen some studies that suggest those who *do* develop prostate cancer while on finasteride may have a greater change of seeing a more aggressive variety. There seems to be conflicting views on whether or not this is true. The general consensus I’ve gathered is that the preventative nature most men see far outweighs the risk, but its something to keep in mind nonetheless.

There seems now to be an agreement amongst the medical community that the appearance of a more aggressive cancer in those patients on finasteride may be a distortion of the way the data is collected. In addition, people on finasteride shrink their prostate when compared to people not on finasteride. If one assumes that both the control group and the treated group start out with the exact same number of cancers (or pre-cancers), then the smaller prostate (when biopsied) will show a higher rate of cancer detection than the larger, more swollen prostate. Each man in the original study was over 55 years old, and as cancer is more prevalent in men over 55. That is why the age group was selected for this study. The men who had an apparently more aggressive cancer had what appears on biopsy to be worse cancers, had the same long term result as than the control group of men. In conclusion, finasteride probably has no more negative effect on producing an aggressive cancer of the prostate than those people who were not on the drug, but the incidence of cancer was 25% less in the treated group than the control group.

For more information, please see Archives of Dermatology – Finasteride (Propecia) and the Promotion of High-grade Prostate Cancer.