Health and Prostate » Questions & Answers

What are the short and long-term side effects of finasteride (Proscar)?

admin — Wed, 14 Apr 2010 07:41:34 +0000

Question: What are the short and long-term side effects of finasteride (Proscar)? Answer: The main side effect is impotence, but only in about 6% compared to 3% on placebo. That is to be expected with men of that age who are followed for a long time. Some men will for one cause or another will report impotence - that's just the natural history of aging. No other significant side effects have been reported, either biochemical or subjectively perceived. This has been very thoroughly studied under the Good Clinical Practice international rules - any disorder that any subject has during the study period is registered, even if it's unrelated to the drug. In our trial, 40% of the men already reported sexual dysfunction at the start of the trial, and we estimated that we might have had over-reporting of impotence because it was listed in the patient information as a possible side effect. When you alert the patients to anticipate a side effect, it is more frequently reported because they're watching for it and they're going to attribute it to the medication. We have data now for six years of treatment, Read more [...]

How many BPH sufferers could benefit from finasteride (Proscar)?

admin — Tue, 13 Apr 2010 07:39:19 +0000

Question: How many benign prostatic hyperplasia (BPH) sufferers could benefit from finasteride (Proscar)? Which factors determine who should receive it? Answer: This comes down to the question of who is a good responder, and what is a good response. Is it complete abolition of symptoms or just a 50% improvement, enough to make the patient feel just like a normal elderly man? The degree of prostate gland enlargement is the key factor that predicts outcome of treatment. We performed a meta-analysis, pooling the results from similar trials, so we now have data from over 4,000 patients. This analysis clearly showed that men with more enlarged prostates, over 40 g, have a more significant benefit from the drug. The mean size of the prostates in our study was about 41 g, meaning half the men had prostates larger than that, and half smaller. In our estimation, about 40% of patients have the best effect from the drug, significantly better than reported in the trial. About 20% dropped out over the two years of the study, and the main reason was lack of expected efficacy. If you use the principle "intention Read more [...]

BPH patients and the placebo effect

admin — Mon, 12 Apr 2010 07:38:22 +0000

Question: Why are BPH patients particularly prone to the placebo effect? Answer: It's not only benign prostatic hyperplasia (BPH) patients. This is seen with many chronic benign disorders, for example asthma or incontinence. When you first see the patient, they are always worried that it could be something more serious. The patient is reassured by the doctor, and just the fact that they are being checked by a health professional brings some subjective improvement because it alleviates stress and anxiety, which can make any symptom seem worse. The other factor is that if you don't treat BPH at all, the disease fluctuates naturally -- there are good and bad periods, but over the long term it has an overall worsening. It never gets better all by itself. The patient always goes to the doctor when the symptoms are at their worst, and if you have a seasonal variation, whatever you do over the next two or three months the symptoms will seem to improve because of the natural cycle. That's why we had a two-year trial, to try to eliminate the possible bias caused by the natural fluctuation. Read more [...]

Testosterone and dihydrotestosterone

admin — Sun, 11 Apr 2010 07:35:45 +0000

Question: How does inhibiting the conversion of testosterone to dihydrotestosterone prevent prostate growth?

Answer: The metabolite dihydrotestosterone (DHT) is the active hormone inside prostate cells, and it influences the protein synthesis within the cells. This means that the prostate must have a certain level of DHT within its cells to stimulate and maintain protein synthesis. If you lower the level of DHT inside the prostate cells, you stop or maybe even reverse the growth, since the presence of DHT is a prerequisite for the continuous growth of the gland.

Benign Prostatic Hyperplasia: Etiology The exact mechanisms that cause benign prostatic hyperplasia are unknown. Extensive research indicates that hormonal changes and increasing age are clear risk factors for benign prostatic hyperplasia development. Cell culture studies have determined that the androgen dihydrotestosterone has an important role in prostatic growth. ...
Sources of androgen Testosterone is the major circulating androgen, with 90% produced by the testes. More than half of testosterone is bound to sex-binding globulin and 40% is bound to albumin. Only 3% of testosterone remains unbound, and this is the functionally active form of the hormone. ...
Growth Factors The possible role of a nonandrogenic factor in the development of benign prostatic hyperplasia has been suggested by the observation that as the testosterone levels decrease in most aging men, the prostate continues to grow in size. Additionally, the exogenous addition of androgens increase ...
What causes benign prostatic hyperplasia (BPH)? Question: What causes benign prostatic hyperplasia (BPH)? Answer: That is only partly understood. One known factor is aging and the other is presence of the male sex hormone testosterone. The presence of functioning testes are a prerequisite for prostate enlargement. This has been known for ...
Hormonal Mechanisms Role of Androgens The importance of the testis in benign prostatic hyperplasia has been well known since the 1890s when it was found that castration produced dramatic relief of obstructive benign prostatic hyperplasia in approximately 80% of patients. Scott later noted that benign prostatic hyperplasia ...

What causes benign prostatic hyperplasia (BPH)?

admin — Sat, 10 Apr 2010 07:28:16 +0000

Question: What causes benign prostatic hyperplasia (BPH)? Answer: That is only partly understood. One known factor is aging and the other is presence of the male sex hormone testosterone. The presence of functioning testes are a prerequisite for prostate enlargement. This has been known for decades because of reports from countries where, for religious or other reasons, castration is performed on men at a young age - these men never develop BPH. There might be dietary factors, but this has been looked at globally, and no clear factors that provoke BPH have been found as yet. It's very difficult to ascertain the global rates of benign prostatic hyperplasia. No countries have an especially low incidence, but there are many potentially confounding factors. Many Third World countries do not have registries of various diseases, so of course they'd under-report -- and if people don't have good access to health care, then the disease is never diagnosed or registered. There are factors that have been investigated and found not to predispose to BPH: smoking, alcohol consumption and even sex. Read more [...]

What causes elevation in PSA and liver enzymes?

admin — Thu, 21 Jan 2010 06:15:23 +0000

Dear viewer,

Prostate Specific Antigen (PSA) is blood test that is elevated in prostate cancer, benign prostate hypertrophy, prostate trauma, prostate infection, after prostate examination or ejaculation. Liver enzymes in blood can be elevated in many medical conditions. Some examples include viral hepatitis, medication effects, alcoholic liver damage, gallstone disease, cancer in the liver, excessive fat or iron in the liver etc. Therefore it is difficult to directly answer your question regarding relationship between elevated PSA and liver enzymes without more information.

Alkaline phosphatase is a liver enzyme that is also found in bone. Alkaline phosphatase can be elevated in liver disease and in bone diseases such as bone cancer and Paget’s disease of bone. In patients with prostate cancer that have spread to bone, both Prostate Specific Antigen (PSA) and Alkaline phosphatase can be elevated.

Thank you for your question!

Prostatism: Signs Having obtained the symptoms suggestive of outlet obstruction, the diagnosis should then be confirmed by the signs of outlet obstruction. On physical examination, the bladder may or may not be palpable. Rectal examination should normally reveal an enlarged prostate. However, it is the periurethral ...
Osseous Metastases Persistent bone pain in the back or hip region is one of the most common presenting symptoms of metastatic disease. The imaging modality of choice in this situation is the radionuclide bone scan. This will reveal the most common sites of spread to be ...
Atrasentan. Atrasentan (Abbott Laboratories' Xinlay, formerly ABT-627) is an oral, small-molecule, selective ET-A-receptor antagonist that appears to slow the progression of CaP. It is in Phase III trials, and Abbott submitted a new drug application (NDA) for the drug with the FDA at the ...
Leading Prostate Cancer Test ‘Clinically Useless’ PSA test doesn't detect tumor's severity, Stanford University study says The leading test to detect prostate cancer is "clinically useless" at determining the size or severity of a man's tumor, and is only of "limited" value at predicting cure rates from surgery to remove the ...
Prostate specific antigen in urinary tract infection Prostate specific antigen (PSA) has a reported sensitivity for prostatic adenocarcinoma of up to 80%. However, it lacks specificity. The reported positive predicted value of an elevated PSA (Hybritech Tandem-R PSA radioimmunoassay >4 ng/ml) for prostatic carcinoma in screening studies is only 28-33%. This ...

Calcifications in the prostate gland

admin — Thu, 26 Nov 2009 16:22:18 +0000

Question: What is the significance of calcifications in the prostate gland?

Answer: Calcifications within the prostate gland are benign (not harmful) and a common finding. They are frequently detected with x-ray or ultrasound testing, even in the absence of any apparent disease process. Prostatic calculi are common, being reported in approximately 30% of adult males examined using these tests.

They occasionally are found in patients with a history of inflammation of the prostate gland (prostatitis). Larger calcifications (calculi) are commonly associated with benign enlargement of the prostate (benign prostatic hypertrophy).

Radiographic Examination Radiographic examination of patients with chronic bacterial prostatitis and prostatitis inflammatory syndromes is usually unnecessary and findings are nondiagnostic. While patients with tuberculosis prostatitis and granulomatous prostatitis may undergo radiographic examination with diagnostic findings, the majority of patients can be evaluated and treated without ...
Medical Treatment of the Prostate Gland. Part 10 The Department of Urology of the New York Hospital (Given January 31, 1941) Prostatic Calculus Incidence and Etiology. Prostatic calculi are relatively common. In an autopsical study of 250 prostates from subjects of all ages, I found one or more stones in approximately one-fifth of ...
Prostatism: Pathology Prostatism is the clinical syndrome consisting of the symptoms associated with outlet obstruction at the bladder neck. By far the commonest cause of this syndrome is benign prostatic hypertrophy, but other entities such as bladder neck stenosis and urethral strictures can produce these symptoms ...
Acute Bacterial Prostatitis The diagnosis of acute bacterial prostatitis is usually straightforward and readily apparent on physical examination. Patients are frequently febrile and toxic with severe rigors, back pain, perineal pain, dysuria, urgency, and frequency with associated mild to moderate obstructive urinary symptoms. As many as one-third ...
Medical Treatment of the Prostate Gland. Part 3 The Department of Urology of the New York Hospital (Given January 31, 1941) Diseases of the Prostate Gland Prostatitis 2. Chronic Prostatitis Chronic inflammation of the prostate gland is a very common condition in adult males. In our series of 350 postmortem studies, a large number ...

Health and Prostate » Questions & Answers

What are the short and long-term side effects of finasteride (Proscar)?

How many BPH sufferers could benefit from finasteride (Proscar)?

BPH patients and the placebo effect

Testosterone and dihydrotestosterone

Related Posts:

What causes benign prostatic hyperplasia (BPH)?

What causes elevation in PSA and liver enzymes?

Related Posts:

Calcifications in the prostate gland

Related Posts: