Treating BPH Can Also Help Prevent Prostate Cancer

Benign prostatic hypertrophy, or BPH, causes symptoms in more than 50% of men in their 60's and as many as 90% in their 80's. Symptoms include increase frequency of urination, difficulty or hesitancy in starting, a weak stream, and a feeling of inadequate emptying. One popular medication that relieves symptoms in men with large or moderately enlarged prostates is finasteride (Proscar®). It inhibits the amount of testosterone that turns into dihydrotestosterone (DHT), a hormone required for prostate gland growth. Enzyme inhibitors can take up to a year for full benefits to develop, but they may significantly decrease the need for surgery and the incidence of urinary retention.

Now results from a big study have been reported at the American Urological Association Meeting, confirming that finasteride can reduce the risk for most prostate cancers. The Prostate Cancer Prevention Trial (PCPT) enrolled over 18,000 men aged 55 and older, but was discontinued in 2003 because there were preliminary results suggesting that men taking the drug had more aggressive tumors if they did develop cancer.

A new analysis of the biopsies taken from the 18,000 men has been undertaken by researchers from New York-Presbyterian Hospital. They made adjustments for the type of treatment, age, race, family history of prostate cancer, baseline PSA (prostate specific antigen) levels, and the patient’s prostate volume. They found a significant reduction in the frequency of prostate cancers, even the more aggressive ones, in the patients taking finasteride. In particular, finasteride medication was associated with a significant decrease in the tumors with a Gleason score of 5, 6, and 7. And higher scoring (i.e. more aggressive) tumors were not more frequent in the men taking finasteride.

This is good news for men with BPH. They can take enzyme inhibiting medication and expect that they are also preventing the likelihood of developing prostate cancer. The principal investigator of the study is reported to have said: “any man over 55 who is having his PSA checked on an annual basis can have his risk reduced by taking finasteride.” He went on to say that, having a 1 in 6 chance of being diagnosed with prostate cancer, he would probably start on the drug himself when he reached 55 . . .