Pharmacological approaches to reducing the risk of prostate cancer.

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Rittmaster RS, Fleshner NE, Thompson IM

Pharmacological approaches to reducing the risk of prostate cancer.

Eur Urol. 2009 May;55(5):1064-73. doi: 10.1016/j.eururo.2009.01.037. Epub 2009 Feb 5.

PubMed ID

19200641 [ View in PubMed

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Abstract

CONTEXT: It is now possible to reduce a man's risk of developing biopsy-detectable prostate cancer. This review addresses the evidence and issues surrounding prostate cancer risk reduction. OBJECTIVE: The scientific basis, therapeutic approach, and risks and benefits of prostate cancer prevention are reviewed. Special attention is given to data on 5alpha-reductase inhibitors (5-ARIs). EVIDENCE ACQUISITION: Medline searches consisted of articles published since 2003 regarding prostate cancer chemoprevention, prevention, or risk reduction, as well as searches around specific topics within this review. EVIDENCE SYNTHESIS: Current data support the use of finasteride for prostate cancer risk reduction in appropriately selected men. The initial concern that finasteride increased the incidence of high-grade prostate cancer has not been confirmed by subsequent analyses. The efficacy of dutasteride, a dual 5-ARI, for prostate cancer risk reduction is currently being evaluated in men with elevated prostate-specific antigen (PSA). Other medical approaches to prostate cancer risk reduction, including statins, cyclooxygenase-2 (COX-2) inhibitors, selective estrogen receptor modulators, and dietary supplements, await validation in controlled clinical trials. CONCLUSIONS: It is now possible to reduce an individual man's risk of developing biopsy-detectable prostate cancer. The greatest benefit arises from decreasing the amount of unnecessary treatment in men harboring low-risk cancers. Presently, there is no evidence that 5-ARIs or any other approach to prostate cancer risk reduction will reduce the risk of lethal prostate cancers. Finasteride, however, does enhance the utility of PSA for diagnosing high-grade cancers.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Dutasteride	3-oxo-5-alpha-steroid 4-dehydrogenase 1	Protein	Humans	Yes	Inhibitor	Details
Dutasteride	3-oxo-5-alpha-steroid 4-dehydrogenase 2	Protein	Humans	Yes	Inhibitor	Details