A new study released on Jan. 23 claims that the drug dutasteride may prevent the growth of prostate cancer in men, and possibly even be used as a way to protect men from prostate cancer.
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| by Paul R. Sieber, MD, Urological Associates of Lancaster |
While that is a very exciting claim, there are simply too many question marks about this drug to recommend it as an alternative to surgery.
First, let’s take a quick look at the study, which was published in the medical journal Lancet. Dutasteride, commonly known as Avodart, was originally used as a way to shrink prostates in men as they grow older. In fact, two earlier studies suggested that dutasteride was able to protect men from prostate cancer, although the FDA warned that it may leave men vulnerable to more dangerous later-stage cancers and rejected its claim as a cancer preventative medicine.
The latest study compared treatment in men with low-risk prostate cancer using this drug to men in the same condition using a placebo. The results showed that 62 percent of men that took dutasteride showed no growth of the disease after 3 years of active surveillance and no other treatments. But in men that took the placebo, 52 percent saw no growth.
My opinions are:
- it only used small sample involving 289 men so the results must be interpreted with caution
- the prior FDA warning of increased high grade cancer associated with the use of dutatsteride was not seen in this population; this may be attributed to small size but this is a different patient group than the prevention trials with dutasteride
- men with prostate cancer who have very low risk cancer may be able to take dutasteride safely if needed to control symptoms from BPH without seeing an increase in high grade tumors
There’s certainly some cause for cautious optimism that men with low risk prostate cancer may have an effective, non-surgical way to treat early-stage prostate cancer.
I will be watching developments on this very closely. My hope is that this might eventually prove to be part of a treatment plan that can safely allow men to delay or even prevent more invasive treatments for cure of prostate cancer.
Paul R. Sieber, MD, is a urologist and surgeon with Urological Associates of Lancaster, Ltd.