high risk situation

//high risk situation
high risk situation 2016-04-19T17:33:12+00:00

Hi Doctor Myers.
At 62 I had robotic surgery at NY Cornell and was T3CN0M0, clean margins.
4 months after surgery my PSA increased from <0.04 to 0.22. After 8 months I had IMRT together with 7 months of Lupron at MSKCC.
For the last 2 1/2 years my PSA is at <0.05 (MSKCC lowest value).
Considering my high risk situation should I consider taking Avodart or Finasteride (I believe you prefer Avodart)? How often should I take it and how much?

More impotent, I have 2 sons , 32 and 38. Would you recommend for them to consider starting taking Avodart? At what age? At what age should they have their first PSA test?

 

At AIDP we have a comprehensive program of diet, lifestyle and Avodart that we use to slow the PSA doubling time. I would first measure your dihydrotestosterone and only use Avodart if your dihydrotestosterone was above 5 ng/dL. But we would also recommend a Mediterranean diet, correction of any vitamin D deficiency and probably other measures based on the details of your case.
More impotent, I have 2 sons , 32 and 38. Would you recommend for them to consider starting taking Avodart? At what age? At what age should they have their first PSA test? Thanks again for your great medical leadership. David Greenfiled

We now have two randomized controlled trials, one with Avodart and one with Proscar, that show a reduction in the risk of developing prostate cancer. Other studies have shown that the prostate cancer we see clinically in men in their 50-60s likely started while they were in their twenties or thirties. Thus, the use of Avodart or Proscar in your sons has a rationale. However, these drugs are not without their side effects and it is important that your sons review these issues with a physician in some detail so they understand the risks.