Finasteride: Middle-Age Cure-All for Alopecia and Benign Prostatic Hyperplasia? Reply II

The document discussed the use of finasteride for treating benign prostatic hyperplasia (BPH) and its potential role in preventing prostate cancer. While finasteride was shown to reduce the risk of prostate cancer by 24.8%, it also increased the risk of high-grade tumors. Despite these findings, the authors maintained that finasteride should not be withheld for BPH treatment due to its benefits, such as reducing acute urinary retention and the need for surgery. They emphasized the importance of monitoring men on finasteride with regular examinations and adjusting PSA values for accurate interpretation, as finasteride lowers PSA levels. The authors acknowledged the concerns raised by Dr. Federman but concluded that the evidence from the Prostate Cancer Prevention Trial (PCPT) was insufficient to change their prescribing practices for BPH.