“Heavy” drinking, finasteride, and prostate cancer risk

Many men wouldn’t think that drinking four beers over the course of a Sunday afternoon football game was “any big deal” — but maybe it’s a habit one doesn’t want to get into on a daily basis.

According to a report in HealthDay, “Heavy drinking, especially when it’s beer, increases the risk for highly aggressive prostate cancer.” This result comes from a study by Gong et al. just published online in Cancer.

The researchers “did not set out to determine the effect of alcohol consumption on prostate cancer risk, but rather to review data on the effectiveness of finasteride ” collected as part of the Prostate Cancer Prevention Trial. Not only did they discover “that heavy drinking reduces the cancer-preventing effect of finasteride,” the investigators also developed a better understanding about the “relationship between alcohol consumption and prostate cancer risk.”

Apparently, “men who consumed at least 50 grams of alcohol (at least four drinks) daily doubled their risk of high-grade prostate cancer,” a finding that held true in both the “placebo and finasteride arms of the trial,” according to MedPage Today. “Heavy drinking did not influence the risk of low-grade cancer in the placebo arm, but significantly increased the risk in men taking finasteride.” The “overall risk increase in the finasteride group came about from a significant risk reduction in men who drank less than 50 grams of alcohol, combined with finasteride’s lack of effect among heavier drinkers.”

Data for this study came from the 2,129 participants in the Prostate Cancer Prevention Trial (PCPT) who had cancer detected during the 7-year trial and 8,791 men who were determined by biopsy to be free of cancer at the trial end.

Associations of drinking with high-grade disease did not differ by treatment arm. In combined arms, heavy alcohol consumption (50 g of alcohol daily) and regular heavy drinking (> 4 drinks daily on > 5 days per week) were associated with increased risks of high-grade prostate cancer (RR, 2.01 and 2.17, respectively); less heavy drinking was not associated with risk. Associations of drinking with low-grade cancer differed by treatment arm. In the placebo arm, there was no association of drinking with risk of low-grade cancer. In the finasteride arm, drinking ≥ 50 g of alcohol daily was associated with an increased risk of low-grade disease (RR, 1.89); this finding was because of a 43 percent reduction in the risk of low-grade cancer attributable to finasteride treatment in men who drank < 50 g of alcohol daily and the lack of an effect of finasteride in men who drank ≥ 50 g of alcohol daily

The authors themselves conclude that, “Heavy, daily drinking increased the risk of high-grade prostate cancer. Heavy drinking made finasteride ineffective for reducing prostate cancer risk.”

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