Implications of Chronic Finasteride Use for Androgenetic Alopecia in Prostate Carcinoma

The study examined the effects of chronic finasteride use, particularly at 1 mg/day for androgenetic alopecia, on prostate cancer diagnosis and prevention. Finasteride was found to reduce PSA levels by about 50%, which could delay prostate cancer diagnosis if not adjusted for. While it decreased serum dihydrotestosterone levels, prostate levels did not show the same reduction, indicating different effects on cancer outcomes. Finasteride increased hair count and improved hair growth, but had sexual side effects. The Prostate Cancer Prevention Trial with 18,882 men showed finasteride reduced prostate cancer risk, though high-grade tumors were more prevalent, possibly due to detection bias. The study emphasized the need for careful PSA monitoring in patients using finasteride for hair loss and suggested its chemopreventive use was not cost-effective for all men but could benefit high-risk subgroups.