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Preventing Prostate Cancer
Home > Healthy You > Just for Men > Preventing Prostate Cancer > About Prostate Cancer

About Prostate Cancer

Gregory R. Harper, MD, PhD, FACP

Meet the Doctor

Gregory R. Harper, M.D., Ph.D.
Physician in Chief, Cancer Services
Lehigh Valley Hospital and Health Network

Q: I heard there's a new drug that can prevent prostate cancer. Is this true and can I take it?  

 


Dr. Harper: Recently, results were released from the Prostate Cancer Prevention Trial, a national study that enrolled more than 18,000 men to determine whether finasteride reduced the risk of developing prostate cancer. While it is far too early to say for sure if finasteride will indeed be useful in the fight against prostate cancer, we can safely make the following assertions:
  • Finasteride is effective in treating benign enlargement of the prostate gland (BPH), and men who are taking it for this problem should continue under the supervision of their physician.
  • While finasteride may reduce the number of low-grade prostate cancers, it does not protect against the development of high-grade cancers, which are more likely to cause harm to the patient.
  • Based on this study, it is too early to recommend finasteride for the prevention of prostate cancer.
  • Currently ongoing trials, such as the SELECT trial, are examining other strategies to reduce the risk of prostate cancer.
Because finasteride reduces by 90% the level of the most active male hormone in the prostate, it is used for the treatment of benign enlargement of the prostate (BPH) and is successful in treating symptoms of an enlarged prostate gland. This treatment results in better urine flow and a decrease in the number of surgeries required to reduce the size of the prostate (TURP).

In the latest clinical trial, healthy men who had a normal prostate examination and a PSA level of less than or equal to 3 were randomly assigned either to finasteride or an inactive agent (placebo). All men were monitored more carefully than routine practice. There were 6% fewer cancers detected in the finasteride group than in the placebo group (18.4% compared to 24.4%).

More high grade cancers were found in the finasteride group compared to the placebo group, most likely because the finasteride inhibited the growth of lower grade cancers which are more dependent on male hormones for their growth, and did not inhibit high grade cancers which are less dependent on male hormones for growth. It is less likely that finasteride causes the development of high grade cancers.

Side effects experienced by men participating in the trial were typical of either finasteride or placebo. Because finasteride lowers male hormone levels, certain sexual side effects were observed in the finasteride group. However, in the placebo group, there were more symptoms of an enlarged prostate gland, since the men were taking nothing to prevent enlargement of the prostate gland.

If you are interested in reducing your likelihood of developing prostate cancer, be sure to talk with your doctor about the findings of this study, and to review carefully whether you should consider taking finasteride or participate in the SELECT trial.

Sincerely,
Gregory R. Harper, M.D., Ph.D.
Physician in Chief, Cancer Services
Lehigh Valley Hospital and Health Network

This page last updated 9/15/08 02:31 PM
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