Prostate cancer is so so sensitive…to testosterone…hormone sensitivity 101

Everywhere you look today there is an article about Avodart curing cancer, causing high-grade cancer, hiding cancer and as alluded to yesterday on this blog, sparing men from that nasty ole PSA and all the harm it perpetrates on the unsuspecting male. What is Avodart? Well it is like Proscar and like Proscar grows hair, but  I digress. It is an anti-androgen. It is a weak anti-testoserone drug. The reason it helps the male with an enlarged prostate is that it prevents the conversion of testosterone in the prostate and shrinks it. Because it affects testosterone, it will also decrease a male’s PSA. That is where the comment”gives a man false security comes from.” All of the drugs whether it be Avodart, Casodex, or the LHRH shots like Lupron, lower the male hormone testosterone and in turn affect the prostate and prostate cancer. Anti-testosterone drugs put prostate cancer on hold, they do not cure it. Think of decreasing oxygen away from a flame, it diminishes it but doesn’t put it out. Now why is prostate cancer such a sensitive cancer? There are community of cells in the prostate cancer prostate that are very sensitive to testosterone and some that are not. At first, when exposed to the anti-testosterone drugs, the cancer will respond rather dramatically. In time the non-responsive cells become more predominant in the cancer and overwhelm the sensitive ones. This is when the cancer fights through or is no longer sensitive to hormones and is called “hormone refractory prostate cancer.” This is a bad prognostic indicator. So when in all the articles of the last few days speak of cancer being delayed or cured or whatever, it is really only referring to the effect mentioned above. This also why Dr. Walsh mentions the “false sense of security” remark.  There is nothing new in this article in terms in prostate cancer being put on hold by Avodart or any anti-hormone drug. It may have some relevance in terms of when cancers are found they tend to be more aggressive. Clinically when you ask patients whether they would want to find their cancer early or late they overwhelmingly choose early. At this point it becomes a soul-searching excercise between the patient, his doctor, his family, his disease, his gut, and his research. For anyone or any organization to make those decisions for the male patient with prostate cancer seems to me inappropriate.