Drug May Slow Early Prostate Cancer: Study

TUESDAY, Jan. 24 (HealthDay News) — New research suggests that
Avodart, a drug used to treat an enlarged prostate gland, may help slow
the progression of early stage prostate cancer, reducing the need for
aggressive treatment in some men.

Prostate cancer can grow and spread slowly, which is why some men are
urged to engage in so-called watchful waiting when the cancer is first
diagnosed. Avodart (dutasteride) may help such men feel comfortable with
surveillance as opposed to radical treatment, the researchers noted.

“The concept of active surveillance is gaining traction in most parts
of the world,” said study author Dr. Neil E. Fleshner, head of the
division of urology at the Princess Margaret Hospital in Toronto. Still,
some men are uncomfortable with doing nothing in the face of a cancer
diagnosis, he said. “By using this drug, we can improve the proportion of
men who remain committed to the surveillance.”

The findings are published online Jan. 25 in The Lancet.

According to the U.S. National Cancer Institute, one out of every six
men in the United States will develop prostate cancer in his lifetime. But
because many of those cancers are low-grade, most will die of something
else.

Avodart belongs to a class of drugs called 5-alpha reductase
inhibitors. These drugs work by interfering with the effects of certain
male hormones on the prostate. In the three-year study, prostate cancer
progressed in 38 percent of 144 men with early prostate cancer who were
treated with Avodart and 48 percent of the 145 men who received a
placebo.

Men seem less anxious about the cancer diagnosis when they are doing
something more proactive, Fleshner said. “The drug augments active
surveillance and avoids most of the side effects associated with surgery
and radiation,” he said. Prostate removal surgery and/or radiation can
lead to impotence and incontinence, he said.

The medication does have side effects, however, including reversible
breast enlargement and tenderness and some sexual dysfunction.

“We know that we are over-treating prostate cancer,” said Dr. Louis
Potters, chairman of radiation medicine at North Shore University Hospital
and Long Island Jewish Medical Center in Manhasset, N.Y.

“In the U.S., patients have a tendency to hear the word ‘cancer,’ and
want to treat it right away,” he said. “In these men with early prostate
cancer, we can now say, ‘Let’s put you on this medication, and see what
happens over the next couple of months.'”

However, some experts have concerns about 5-alpha reductase inhibitors.
The U.S. Food and Drug Administration recently issued a warning that men
who take these drugs to treat enlarged prostate glands may be at increased
risk for high-grade prostate cancer.

Dr. Ryan Terlecki, an assistant professor of urology at Wake Forest
Baptist Medical Center in Winston-Salem, N.C., said this may dampen
enthusiasm for use of the drug to treat cancer.

“The overall role that these medications will play for urologists will
decrease,” Terlecki said. Doctors will likely begin looking toward
noninvasive and/or non-medical treatments such as the use of thermal heat
to cope with some of the symptoms of prostate conditions, he added.

More information

Learn more about prostate cancer at the American Cancer Society.

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