Stabilization of Prostate Cancer with Amanita phalloides: Intervals with 5-Alpha-Reductase Inhibitors and Melatonin to Circumvent Resistance: Case Report

Prostate cancer (CaP) is one of the leading causes of death in men worldwide. Much attention has been given on its prevention and treatment strategies, including targeting the regulation of 5-alpha-Reductase (5αR) enzyme activity, aimed to limit the progression of CaP by inhibiting the conversion of potent androgen dihydrotestosterone from testosterone that is thought to play a role in pathogenesis of CaP, by using the 5-alpha-Reductase inhibitors (5αRis) such as finasteride and dutasteride. However, 5αRis are reported to exhibit numerous adverse side effects, for instance erectile dysfunction, ejaculatory dysfunction and loss of libido. This has led to a surge of interests on plant-derived alternatives that might offer favourable side effects and less toxic profiles. Phytochemicals from plants are shown to exhibit numerous medicinal properties in various studies targeting many major illnesses including CaP. Therefore, in this review, we aim to discuss on the use of phytochemicals namely phytosterols, polyphenols and fatty acids, found in various plants with proven anti-CaP properties, as an alternative herbal CaP medicines as well as to outline their inhibitory activities on 5αRs isozymes based on their structural similarities with current 5αRis as part of CaP treatment approaches.

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Phytochemicals With Anti 5-alpha-reductase Activity: A Prospective For Prostate Cancer Treatment

F1000Research ◽

10.12688/f1000research.51066.3 ◽

2021 ◽

Vol 10 ◽

pp. 221

Author(s):

Aziemah Azizi ◽

Nuramalina H Mumin ◽

Naeem Shafqat

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Reductase Activity ◽

Treatment Strategies ◽

Prostate Cancer Treatment ◽

Reductase Inhibitors ◽

Ejaculatory Dysfunction ◽

Medicinal Properties ◽

Loss Of Libido ◽

5 Alpha Reductase Inhibitors

Prostate cancer (CaP) is one of the leading causes of death in men worldwide. Much attention has been given on its prevention and treatment strategies, including targeting the regulation of 5-alpha-Reductase (5αR) enzyme activity, aimed to limit the progression of CaP by inhibiting the conversion of potent androgen dihydrotestosterone from testosterone that is thought to play a role in pathogenesis of CaP, by using the 5-alpha-Reductase inhibitors (5αRis) such as finasteride and dutasteride. However, 5αRis are reported to exhibit numerous adverse side effects, for instance erectile dysfunction, ejaculatory dysfunction and loss of libido. This has led to a surge of interest on plant-derived alternatives that might offer favourable side effects and less toxic profiles. Phytochemicals from plants are shown to exhibit numerous medicinal properties in various studies targeting many major illnesses including CaP. Therefore, in this review, we aim to discuss the use of phytochemicals namely phytosterols, polyphenols and fatty acids, found in various plants with proven anti-CaP properties, as an alternative herbal CaP medicines as well as to outline their inhibitory activities on 5αRs isozymes based on their structural similarities with current 5αRis as part of CaP treatment approaches.

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Prostate Cancer Mortality and Use of 5-Alpha Reductase Inhibitors

The World Journal of Men s Health ◽

10.5534/wjmh.190129 ◽

2020 ◽

Vol 38 (2) ◽

pp. 139

Author(s):

Cara A. Foldes ◽

Run Wang ◽

Steven E. Canfield

Keyword(s):

Prostate Cancer ◽

Cancer Mortality ◽

Prostate Cancer Mortality ◽

Reductase Inhibitors ◽

5 Alpha Reductase Inhibitors

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Role of 5-alpha-reductase inhibitors in active surveillance of patients with low-risk prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.14 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 14-14

Author(s):

Andrew Szehsun Chiang ◽

D. Andrew Loblaw ◽

Vibhuti Jethava ◽

Perakaa Sethukavalan ◽

Liying Zhang ◽

...

Keyword(s):

Prostate Cancer ◽

Doubling Time ◽

Low Risk ◽

Reductase Inhibitors ◽

Psa Doubling Time ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer ◽

5 Alpha Reductase Inhibitors ◽

Doubling Times

14 Background: Active surveillance (AS) is a recognized management option for low-risk prostate cancer. Many institutions use serial PSA values to determine when to reclassify patients into higher risk categories. The impact of 5-alpha-reductase inhibitors (5-ARIs) in this setting has not been well studied. The purpose of this retrospective review was to compare PSA doubling time prior to the initiation of a 5-ARI (pre-5-ARI) to that after the PSA nadir (post-nadir) has been reached. Methods: Between 1996 and 2010, a total of 100 patients with a history of 5-ARI use were captured from our AS database. Of these, twenty-nine had a sufficient number of PSA values to determine both pre-5-ARI and post-nadir doubling times. The majority had stage T1c disease (89.7%) and Gleason scores of six or lower (93.1%). The average PSA at presentation was 6.93 µg/L. More patients were prescribed dutasteride (79.3%) than finasteride (20.7%). PSA doubling time was calculated using the general linear mixed-model method. Statistical analysis was performed using the non-parametric sign test. Results: Median follow-up was 69.5 months (mo). For the twenty-nine patients analyzed, the median pre-5-ARI PSA doubling time was 55.8 mo (6-556.8 mo), while that for the post-nadir values was 25.2 mo (6-231 mo) (p=0.0081). Six patients were ultimately reclassified after an average of 67.7 mo (59-95 mo), due to progression in either PSA doubling time (n=2) or Gleason score (n=4). The median pre-5-ARI and post-nadir doubling times for this group were 48.2 mo (32.4-91.1 mo) and 23.3 mo (6-44.3 mo), respectively. Five of the patients underwent radical prostatectomy, while one underwent radiotherapy with androgen deprivation. Of the six patients, one had biochemical failure after an average post-treatment follow-up of 21.3 mo (0-52 mo). Conclusions: In AS for low-risk prostate cancer, it was found that 5-ARIs significantly decreased PSA doubling time. This effect may be related to preferential suppression of benign prostatic tissue, thereby providing a more accurate depiction of the true cancer-related doubling time. If validated with a larger cohort, 5-ARIs may enhance the utility of PSA doubling time as a biomarker of disease progression in AS.

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