But then there’s the other side of the coin. Quite a few folks, along with @Ludovic, @DeStrider, and @tfl.phd, have shared not-so-great experiences with finasteride. It’s a bit of a mixed bag, like always.
With the discussion around Finasteride and its alternatives, I’m wondering if anyone knows of any newer prescription medications that are on the radar for preventative treating prostate issues. I’m interested in staying updated on the latest preventative treatments and their developments.
Even if you’re part of the 1-3% of people who get side effects from finasteride, adding tadalafil (another great product for prostate health) will mitigate most of them, as @Agetron said.
The sheer beauty of the retrospective study linked below is the vast
superiority in Recurrence Free Survival from prostate cancer for Prazosin users over a ten-year period not
only against controls, which could be selection bias, but against a similar drug ,
Tamsulosin, which IMHO means that selection bias is less likely. Prazosin and Tamsuolosin
are both used for LUTS, lower urinary tract symptoms, But they are of different subtypes with some different characteristics
which could account for their spectacularly different outcomes. See the startling diagram with blue and red color for each drug.
Prostate cancer (PCa) remains a significant global health concern, being a major cause of cancer morbidity and mortality worldwide. Furthermore, profound understanding of the disease is needed. Prostate inflammation caused by external or genetic factors is a central player in prostate carcinogenesis. However, the mechanisms underlying inflammation-driven PCa remain poorly understood. This review dissects the diagnosis methods for PCa and the pathophysiological mechanisms underlying the disease, clarifying the dynamic interplay between inflammation and leukocytes in promoting tumour development and spread. It provides updates on recent advances in elucidating and treating prostate carcinogenesis, and opens new insights for the use of bioactive compounds in PCa. Polyphenols, with their noteworthy antioxidant and anti-inflammatory properties, along with their synergistic potential when combined with conventional treatments, offer promising prospects for innovative therapeutic strategies. Evidence from the use of polyphenols and polyphenol-based nanoparticles in PCa revealed their positive effects in controlling tumour growth, proliferation, and metastasis. By consolidating the diverse features of PCa research, this review aims to contribute to increased understanding of the disease and stimulate further research into the role of polyphenols and polyphenol-based nanoparticles in its management.
Open access paper:
Inflammation in Prostate Cancer: Exploring the Promising Role of Phenolic Compounds as an Innovative Therapeutic Approach
@RapAdmin How much Astaxanthin do you currently take and where do you buy it from? I still am taking 10 mg NOW brand daily. I’d like more if I could find a bulk source.
Personnaly because I am under 50 years old and I get my PSA checked every 4 months, I don’t take a 5-AR blocker, even though I am on TRT. But if I would see a significant rise of my PSA levels that’s not caused by an infection , I would probably start taking a low dose of dutasteride
Everyone else:
Anyone interested in prostate health should read this…get to the list of well known plant compounds (polyphenols) that support prostate health. Eat a diverse plant based diet or find supplements.
I’m on this as I am looking to avoid the harsh chemicals for as long as I can.
If supplements really worked that well there’d be no need for medication in the first place. As long as the “Harsh chemicals” don’t affect all-cause mortality and you’re not part of the small minority who get side effects from dutasteride/finasteride/tamsulosin/tadalafil/etc., I don’t see why you shouldn’t take them.
The lowest dose that supposedly works for hairloss is 0.5mg once a week. I don’t know if taking it once every two weeks suppressed enough DHT in the prostate’s tisue.
Aspirin and other nsa seem to have a profound impact on prostate health. It was covered a bit in the article above.
Another citation… shows the following conclusion “After adjustment for age, NSAID use was significantly inversely associated with onset of moderate/severe urinary symptoms.”
I had dropped low dose aspirin given recent negative findings, but I am back on it given the above sources.
The Aspree study (see below) influenced my recent thinking to drop aspirin at my age (69). But counter to this study, it seems aspirin can be protective against colon cancer if taken before 65. So I thought at my age it wise to give it up as I already received the benefit. But the studies given above make aspirin (and other nsa) as almost miracle drugs against prostate cancer and prostate growth. It seems to me that this boils down to aspirin effectively combating low grade inflammation - inflammation being the main contributor to the aging prostate problem.
The ASPREE trial enrolled older adults (70 and older; African-Americans and Hispanics 65 and older). Both trials showed that low dose aspirin (at 100 milligrams per day) did not prevent subsequent heart attacks or strokes over a period of approximately five years. However, aspirin did increase the risk for major bleeding. Furthermore, in the ASPREE trial, there were more deaths attributed to aspirin use. Michos finds the new results “alarming” and says that most adults without known heart disease should not take aspirin routinely for heart attack and stroke prevention.
The risks you cite give pause, particularly the McNeil 2018 paper about bleeding. But I am wondering if the risk can be mitigated with enteric coating, taking aspirin with food, etc. Right now I am thinking that combating low grade inflammation is of utmost importance at my age, and I am back on the aspirin train. I will look into risk management with its use though.
I find piperlongumine very interesting.I have read quite a lot of studies that show fascinating results. Piperlongumine seems to be bioavailable and effective at rather low dosing. But should not be combined with antioxidants.
" Metastatic castration-resistant prostate cancer (CRPC) is the leading cause of death among men diagnosed with prostate cancer… The results showed that PL exhibited stronger anticancer activity against CRPC compared to that of taxol, cisplatin (DDP), doxorubicin (Dox), or 5-Fluorouracil (5-FU), with fewer side effects in normal cells. Importantly, PL treatment significantly decreased cell adhesion to the extracellular matrix and inhibited the migration of CRPC cells"
The main question for me revolves around making the information about polyphenols and their role in inflammation actionable, particularly in the context of cancer prevention. Polyphenols, known for their antioxidant and anti-inflammatory properties, are considered beneficial in this regard. However, determining the appropriate amount of polyphenols or supplements to take is complex.
For example, engaging the NRF2-ARE pathway is considered today crucial for cancer prevention. This pathway plays a key role in cellular defense against oxidative stress. However, as highlighted in the article from PubMed (The Effects of Dietary Supplements that Overactivate the Nrf2/ARE System - PubMed), overactivation or constant activation of the Nrf2/ARE antioxidant system can potentially contribute to various diseases, including certain types of cancer, autoimmune, neurodegenerative, and cardiovascular diseases. This paradox indicates that while activation of this pathway can be beneficial, its overstimulation can be detrimental.
Given this complexity, the idea of cycling the intake of polyphenols or related NRF2-ARE supplements might be feasible. This could mean limiting intake to certain days of the week, such as 2 days a week, or perhaps on a weekly cycle. However, there isn’t a definitive answer yet on the optimal cycling pattern today.
