Why don’t most men consider prevention?


There are a couple of interesting new commentaries that discuss the idea of using 5α-reductase inhibitors to prevent prostate cancer (and other agents to prevent breast cancer).

In the Philadelphia Inquirer yesterday, there was a long article about the use of drugs like tamoxifen and raloxifene to prevent breast cancer that also talks about the use of finasteride and dutasteride to prevent prostate cancer. And earlier this month there was an editorial about the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial published in European Urology by Fritz H. Schröder and Monique J. Roobol. A media release about this editorial has just been sent out by the European Association of Urology.

The basic problem with the use of drugs to prevent cancer seems to be that — as a society — we have yet to appreciate that it is the highest risk patients who stand to have the greatest benefit form this type of care. It is unrealistic to think that everyone over 50 should be taking dutasteride. But it is equally unrealistic not to see if we can work out a set of sound criteria that would define patients who should be considering this type of therapy.

One Response

  1. You say: “… We have yet to appreciate that it is the highest risk patients who stand to have the greatest benefit form this type of care.”

    Myabe I have misread or simply misunderstood the pieces I have read about finasteride and dutasteride but I have until now been under the impression that the studies that have been carried out were with men who might be termed low risk.

    And how do the apparent reductions in positive biopsy after treatment compare with the reduction in positive biopsy results in men on AS? It has been said that about 25% of these men have negative secondary biopsy results. Hmmmm … ?????

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