Other Benefits of Finasteride

Are there other benefits to finasteride in addition to hair maintenance?

Almost everyone periodically looks at the medications they take and wonders, “Do I really need to be taking this?”  So if you are looking at your finasteride and wondering the same thing, let me give you a reason in addition to maintaining your hair to stick to your regimen: lifetime reduction in the risk of developing prostate cancer.

A male in the United States has a 16.5% chance of developing prostate cancer at some point in their life (1).   The Prostate Cancer Prevention Trial (PCPT) launched in 1994 found that finasteride reduced the relative risk of developing prostate cancer by 24.8%.  1147 of the 4692 men in the placebo group developed prostate cancer during the trial compared to 803 of the 4368 men in the finasteride group (2).   If you don’t read a lot of medical literature and a 25% relative risk reduction in cancer doesn’t sound like a lot, I’ll just tell you that it’s a lot.  Like a lot, a lot.  In fact, its so significant that the PCPT was stopped 15 months earlier than planned because it was determined it was unethical to keep the placebo group patients on a placebo for another 15 months when they could be getting the benefits clearly seen in the finasteride group.

The only concerning thing found was that those in the finasteride group had a slightly higher incidence of high grade cancers (3.5% of the finasteride group vs 3.0% of the placebo group).  A number of studies after the PCPT suggested that the increase in high-grade prostate cancers in the finasteride group may be, in part, due to increased detection as finasteride shrinks the volume of the prostate making high-grade cancers easier to detect.  So to follow up on this issue, the patients in the PCPT were followed out for up to 18 years and an additional year of prostate cancer incidence beyond what the original PCPT investigated was studied (3).

The extra period of surveillance revealed an even greater relative risk reduction of developing prostate cancer of 30% for the finasteride group compared to the placebo group (10.5% of men in the finasteride group vs 14.9% of men in the placebo group).  The slightly higher incidence of high grade cancers was confirmed but it was determined that mortality from cancer was the same in both groups.  Thus taking finasteride doesn’t change the mortality from prostate cancer but it very significantly reduces the morbidity associated with prostate cancer by significantly reducing the overall incidence of the disease.

The ultimate bottom line: I work regularly with 6 different urologists who deal with prostate cancer routinely.  They all say they recommend daily finasteride to their patients that can tolerate the sexual side effects for reasons related to prostate cancer risk reduction; for the the benefit of hair loss prevention is just icing on the cake.