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Avodart May Lower Prostate Cancer Risk

Study Shows Fewer Cancers Diagnosed in Men Who Took the Drug

Reducing Prostate Cancer Risk continued...

He adds that the drug appears most effective for lowering the risk of medium-grade tumors.

About 70% of men with prostate cancer in the study, and in the prostate cancer population at-large, have medium-grade tumors that may or may not grow to the point where they become deadly, he says.

"Once there is a diagnosis of prostate cancer about 80% to 90% of men in the U.S. choose aggressive treatment, which can result in life-altering side effects," he says. "If a man in this midrange [risk] category takes this drug he may never have to make this decision because his cancer may never be diagnosed."

The researchers found no increase in aggressive, high-grade tumors in those who took Avodart for four years.   However, in looking solely at years three and four of the study, investigators noted 12 high-grade tumors in men in the Avodart group and one in the placebo group.

The investigators speculate that if the men in the placebo group who had been diagnosed with medium-grade tumors in years one and two had remained in the study (they were withdrawn after prostate cancer was diagnosed as required by the study) they might have been found to have high-grade tumors on biopsy in years three and four.

ED, Heart Failure, and Avodart

Roughly 9% of the men in the Avodart arm of the study reported some erectile dysfunction, compared to about 5.7% of those in the placebo group.

The researchers also reported an unexpected increase in heart failure rates among the Avodart-treated patients.

A total of 0.7% of the men on Avodart and 0.4% of the men not treated with the drug were diagnosed with heart failure.

The difference was not statistically significant, and no difference in deaths from cardiac causes was seen.

In further analysis, the researchers found that close to half of the heart failures in the active-treatment group occurred among men who were also taking alpha-blockers. Alpha-blockers are used to treat high blood pressure and prostate enlargement.

GlaxoSmithKline spokesman Rob Perry tells WebMD that no evidence of an increase in heart failure risk has been reported over a decade of use in men taking Avodart to shrink enlarged prostates.

Second Opinion

In an editorial published with the study, Johns Hopkins Medical Institution professor of urology Patrick C. Walsh, MD, argues that Avodart and Proscar do not prevent prostate cancers, but instead "merely temporarily shrink tumors that have low potential for being lethal."

He adds that by suppressing PSA levels, the drug could give men a false sense of security and possibly delay diagnosis.

"This drug has side effects, it costs $4 a day, and I do not believe its use for chemoprevention will result in a meaningful reduction in clinically relevant prostate cancers," Walsh tells WebMD.

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