Dear Dr. Roach: Ive had low-grade prostate cancer for several years and am presently on active surveillance. My PSAs have been high but steady, running around 7.8 to 9.2. I have a greatly enlarged prostate, which I believe contributes to the high PSA numbers.
I would like your opinion regarding finasteride (Proscar), as I am considering taking it. I see one of its side effects is that it increases the risk of developing a very serious form of prostate cancer. Since I already have this cancer, am I at an increased risk of mine growing more aggressive? D.N.W.
Answer: A 2013 study showed that although finasteride reduced the overall risk of prostate cancer from 15% to 10% in men followed up to 18 years on finasteride, there was a small increase in high-grade, aggressive prostate cancer, from 3% to 3.5%. However, there was no increased risk of prostate cancer death among treated men.