Can we prevent prostate cancer?

25 July 2011

Finasteride moleculeThe current New England Journal of Medicine contains an editorial review of recent research on the use of finasteride or dutasteride to prevent prostate cancer.

These drugs, known as 5-alpha-Reductase Inhibitors, reduce the effects of male hormones in the body.  It has been suggested that they might be able to prevent prostate cancer, which is known to be affected by these hormones. 

Unfortunately, the evidence has shown that they might make matter worse.

The drugs were evaluated by the US Food and Drug Administration (FDA).  Their conclusion was that the they caused:

"...a relative reduction of approximately 25% in the overall incidence of prostate cancer and a significantly increased incidence of high-grade prostate cancers."

It is possible that the increased risk of high-grade cancer could be down to detection bias in the studies.  The drugs used could affect the way biopsies and PSA tests work for those patients.  This could result in an increase in the detection of aggressive prostate cancers that might otherwise have gone unnoticed during the studies.

Nevertheless, the editorial concludes that there is too much uncertainty around potential adverse effects to recommend the use of either finasteride or dutasteride to prevent prostate cancer.

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Page last edited: 02 October 2011