Cancer Drug Called Worth Risk
Feb. 28–A major study on prostate cancer ended in a quandary last year when findings suggested healthy men who took a common drug developed fewer low-grade cancers but increased their risk for a more aggressive form of the disease.
Now a new analysis by the same scientists concludes the benefits of taking the drug far outweigh the risks.
If all healthy older men started taking finasteride, they would collectively gain more than 316,000 extra years of life over the next 10 years, according to a statistical analysis by the Southwest Oncology Group. The group directed the Prostate Cancer Prevention Trial that ended last year.
“It looks like you are hard pressed to pick a person who doesn’t potentially benefit,” said Dr. Ian Thompson, a professor at the University of Texas Health Science Center who directed the original study of 19,000 men.
Prostate cancer is the second-most common form of cancer and the second-leading cause of cancer deaths among men. It strikes about 220,900 men each year and kills 28,900. Those most at risk include men older than 65, African American men and those with a family history of the disease.
The study found men who took finasteride for seven years reduced their overall risk of prostate cancer by almost 25 percent. But the study also suggested men who took the drug had 7 percent more aggressive tumors than men who took a placebo.
Researchers are still analyzing the results and say there may be reasons why the data on more aggressive tumors are not conclusive. The researchers acknowledge the early results raised questions for doctors and patients.
“Without any way to measure it, people just assumed that the risks canceled out any benefits,” said Joseph Unger, a biostatistician at Fred Hutchison Cancer Institute in Seattle who directed the latest analysis. “So this is the first time we sat down to do what amounts to a risk-benefit analysis, and we found out that the benefits far outweigh the risks.”
The study is being published today in the online version of the journal Cancer.
Finasteride is sold under the brand name Proscar to treat enlarged prostates and as Propecia to treat baldness. It suppresses the development of DHT, the most prevalent of the testosterone-like group of hormones called androgens.
Thompson said he already is prescribing the drug for his healthy patients and suggests other men talk about the medication with their doctors. He noted the average man has a 17 percent risk of developing cancer in his lifetime.
“We do a lot of things like wear seat belts when the risk (of an accident) may be half a percent or one-tenth of a percent,” Thompson said. “When your lifetime risk is 17 percent, these data would suggest there are lots of ‘person years’ where people will be around to enjoy life if they decide to (take the preventative.)”
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