Drug May Help Prevent Prostate Cancer
New Guidelines for Healthy Men to Talk to Their Doctors About Taking Proscar
Key Recommendations continued...
The discussion is likely to be complicated. Among the factors to consider:
- When the findings from PCPT first came out, use of Proscar appeared to be associated with an increased risk of developing high-grade tumors, which are more likely to spread. A more thorough look at all the evidence now suggests "that the increase in high-grade cancers among men on Proscar was most likely an artifact," Kramer tells WebMD. Still, uncertainty exists.
- The therapy could prove costly and it is unclear whether insurance companies will pay. According to Kramer, "you would have to treat 71 healthy men for about seven years to prevent one case of prostate cancer."
- Prostate cancers are so slow-growing that many cancers prevented by the use of 5-ARIs may never cause harm in the first place.
- It is still not known whether taking a 5-ARI will reduce the risk of dying from prostate cancer or extend life expectancy.
- There are possible, though typically reversible, side effects associated with the use of 5-ARIs. They include an increased risk of erectile dysfunction and a decrease in libido and ejaculation volume.
- The use of 5-ARIs carries certain benefits, chiefly a decreased risk of lower urinary tract symptoms such as having trouble urinating.
Howard M. Sandler, MD, a prostate cancer specialist at Cedars-Sinai Medical Center in Los Angeles, says that he would consider taking a 5-ARI for prostate cancer prevention on a trial basis.
"If I tried it for a month or two and developed side effects, it would probably not be worth taking. But if I had no side effects, I probably would take it. It might help me sleep better at night," he tells WebMD.
The guidelines will be published in the March issue of the Journal of Clinical Oncology and the March issue of The Journal of Urology.