Does Finasteride cause cancer? Will it increase the risk of prostate cancer?

What is Finasteride? Why is it used in the treatment of androgenic alopecia?

Finasteride (Propecia) is a 5α-reductase inhibitor. Its primary function is to inhibit the conversion of testosterone into DHT (dihydrotestosterone).

DHT is one of the key factors contributing to the progression of androgenic alopecia. It causes hair follicles to gradually shrink, leading to hair becoming finer and thinner, hair loss, and even recession of the hairline as well as thinning at the crown.

Main Actions of Finasteride

• Inhibits the conversion of testosterone to DHT
• Reduces the impact of DHT on hair follicles
• Delays the progression of androgenic alopecia
• Helps maintain existing hair volume

Common Uses of Finasteride

Since DHT is closely related to follicular atrophy and prostatic hyperplasia, Finasteride is widely used in dermatological and urological treatments.

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Does Finasteride Increase the Risk of Prostate Cancer?

The most representative study currently is the large-scale clinical trial PCPT (Prostate Cancer Prevention Trial).

Key Points of the PCPT Study

This study primarily explored the relationship between Finasteride and prostate cancer.

This study found that men using Finasteride had an overall incidence of prostate cancer that actually decreased by about 25%.

However, the study also found a slightly higher detection rate for high-grade prostate cancer. This is also the primary source of the online claim that "Finasteride causes cancer."

Why is there a misunderstanding about "increased high-grade prostate cancer"?

Subsequent multi-analyses and long-term follow-up studies indicate that the slightly higher detection rate of high-grade prostate cancer does not actually mean that Finasteride causes cancer.

The main reasons include:

• Finasteride causes the prostate volume to shrink
• After the prostate shrinks, prostate biopsies more easily target the affected area
• PSA testing and prostate biopsy accuracy may be improved
• High-grade cancers that already existed are more easily detected

In other words, this is more likely an increase in detection rate rather than Finasteride causing an increase in cancer.

Long-term Follow-up Results

Results showing more than 15 years of follow-up:

Patients using Finasteride did not have an increased risk of lethal prostate cancer or mortality.

Therefore, simply stating "Finasteride causes cancer" is inaccurate and easily causes unnecessary panic.

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Is low-dose Finasteride 1mg safe for treating male pattern baldness?

The common Finasteride dose for treating male pattern baldness is 1mg daily, which is lower than the 5mg dose used for treating benign prostatic hyperplasia (BPH).

Current medical evidence shows:

• No increased risk of prostate cancer has been found with 1mg Finasteride
• No increased risk of other cancers has been found
• Long-term use is considered safe and effective clinically
• It is suitable for use under a doctor's evaluation and monitoring

For young men taking Finasteride due to male pattern baldness, there is currently no evidence suggesting an increase in cancer risk.

Will Finasteride Cause Other Cancers?

As of current research, there is no clear evidence that Finasteride increases the risk of the following cancers:

• Breast cancer
• Liver cancer
• Other common cancers

However, in extremely rare cases, male breast lumps, breast pain, or breast changes have occurred.

Although the incidence is very low, if the following symptoms occur during medication, you should seek medical attention immediately:

• Breast lumps
• Breast pain
• Nipple discharge
• Clearly enlarged or asymmetrical breasts

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Physician Recommendations for Taking Finasteride

To ensure medication safety, the Apex Clinic recommends that the patient be assessed and monitored by a physician before and after taking Finasteride.

Recommendation 1: Establish a PSA Baseline Before Starting Medication

If you are older, have prostate issues, or have a family history, it is advisable to establish a PSA baseline value before taking the medication for future comparison.

Recommendation 2: Regular PSA Monitoring for Long-Term Users

Finasteride may reduce PSA levels by approximately 50%; therefore, PSA results require medical interpretation and cannot be interpreted solely based on the raw numbers.

Recommendation 3: Consult a Physician If You Have a Family History of Prostate Cancer

If someone in your family has a history of prostate cancer, it is recommended to consult a dermatologist or urologist before taking the medication.

Recommendation 4: Seek Medical Re-evaluation Immediately if Abnormal Breast Symptoms Occur

If symptoms such as breast lumps, pain, or discharge occur during medication, seek medical re-evaluation as soon as possible.

Finasteride Cancer Risk Summary

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Conclusion: Finasteride is not synonymous with cancer; the key lies in proper evaluation and follow-up

Overall, current medical evidence shows that Finasteride does not increase the overall risk of prostate cancer.

The claim of "increased high-grade prostate cancer" in past studies has been analyzed in subsequent studies, suggesting it is more likely related to prostate volume reduction and increased detection rates, rather than Finasteride directly causing cancer.

For patients with male pattern baldness, the low-dose Finasteride 1mg remains one of the important medications for its treatment. Under doctor evaluation, proper use, and regular follow-up, Finasteride can serve as a safe and effective treatment option.