Finasteride prevention prostate
Men and their physicians need not hesitate to use a drug proven
effective in preventing prostate cancer out of concern that it is
likely to cause sexual dysfunction, say authors of a study conducted by
the Southwest Oncology Group.
The authors, who surveyed more than 17,000 men 55 and older for seven years,
reported their results in the Journal of the National Cancer Institute.
The study found that men given finasteride reported on average more
dysfunction than did men given a placebo. That small effect diminished
over the seven years.
The results allay concerns about a negative side effect associated
with finasteride up till now. Physicians usually warn that sexual
dysfunction is a possibility when they discuss the drug with patients. Finasteride
is an FDA-approved drug for the treatment of benign prostatic
hyperplasia, but it is not yet FDA-approved for the prevention or
reduction in risk for prostate cancer.
The study’s large sample and long follow-up period allowed
researchers to examine whether or not finasteride negatively affected
sexual function and, if so, whether this effect was lasting, said Carol
Moinpour, Ph.D., of the Fred Hutchison Cancer Research Center in
Seattle, the study’s lead author. She coordinates quality-of-life
studies for the Southwest Oncology Group, the nation’s largest National
Cancer Institute-funded clinical trials network.
The study grew out of the Prostate Cancer Prevention Trial, a large
double-blind National Cancer Institute-funded study which found that
finasteride, a drug which curbs the proliferation of prostate gland
cells, is effective at preventing prostate cancer in men age 55 and
older. The 2003 results of that trial, conducted by the Southwest
Oncology Group in more than 18,000 men, showed that finasteride could
reduce a man’s chances of getting prostate cancer by almost 25 percent.
The authors of the newly published sexual function results wanted to
assess how many men in the Prostate Cancer Prevention Trial reported
experiencing sexual dysfunction, and whether the problems decreased or
increased over time. In earlier studies, some men taking finasteride
reported decreased libido, impotence and other signs of diminished
sexual function. But these studies were short-term and didn’t try to
assess the effects of age and other health factors, as well as
individual variation.
“Millions of men may benefit from finasteride’s ability
to reduce prostate cancer risk,” said Leslie Ford, M.D., who oversaw
PCPT for the Institute. The nation’s number one cancer doctor,
Andrew C. von Eschenbach, Director of the NCI, called it a “landmark
study.” The story appeared on the front
page of the New York Times, and it was widely covered by other major
news agencies such as CNN
and The Wall
Street Journal. At the press conference, which will be available
online as a webcast for the next year, Dr. Peter Greenwald, Director
of Cancer Prevention for the NCI, said, “This trial proves that
prostate cancer is at least in part preventable. It is a huge step forward.”
On the day
of the NCI press conference, USRF Director Leonard S. Marks, M.D., appeared
live on CNN television to explain the importance of PCPT.
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