In the News – Finasteride and Dutasteride Raise Prostate Cancer Risk
Snippet from the article:
A class of drugs meant to improve symptoms of an enlarged prostate gland actually increase the chance of getting a more serious form of prostate cancer, health officials said on Thursday. However, they also said the drugs’ benefits outweigh the risks.
The drugs in this group include Merck & Co’s Proscar and GlaxoSmithKline’s Avodar and Jalyn, as well as Merck’s Propecia, which is approved to treat male pattern hair loss.
The Food and Drug Administration said it revised the labels on all such drugs, called 5-alpha reductase inhibitors (5-ARI), to include the risk after reviewing two large studies.
Read the rest — Prostate drugs raise risk of prostate cancer: FDA
Today comes news that the FDA is warning that drugs like Avodart and Proscar may increase the risks of some forms of prostate cancer.
In the original studies, the overall incidence of prostate cancer in the thousands of individuals enrolled in a double blind FDA sponsored activity showed that overall risks of cancer in those men treated with 5mg finasteride (Proscar) saw a 25% decrease in risk of developing prostate cancer. After the study was published, pathologists looked at the types of cancer that they saw, and reported that of those fewer men that did develop prostate cancer, the presence of more aggressive cancers was greater in that group.
These risks are very small and the overall reduction of prostate cancer standing at 25% in the 7 year trial should offset the other risks of a more aggressive cancer, but the statistics on this are dubious at best. For those men who are taking finasteride (at any dose), they must recognize that there is a risk of a more aggressive prostate cancer, no matter how small that risk is.
The information about cancer reflects the experience with finasteride 5mg (Proscar), not 1mg for treating hair loss (Propecia). What we do not know is the threat of the 1mg dose, if any. There have been no reports that separate the 5mg and the 1mg dose in the cancer risk scenario.
Dr,
Did the study show these drugs caused the cancer or simply mask some cancers that were there anyway until it became a stage2?
Thanks
Here is what another Dr. says.
Otis Brawley, chief medical officer of the American Cancer Society and a prostate cancer doctor himself, what he thought. Brawley wrote back:
I and most docs who have reviewed the data believe that these drugs cause small high grade tumors that already exist to be more easily diagnosed by shrinking the normal prostate and not the cancer within it. It is does not cause high grade cancer in my opinion. There are a small number of people who think these drugs might cause high grade cancer. I seriously do not see evidence for that.
Eli – Yes, my son will continue to take it and I will continue to prescribe it.
Dr. Rassman, while it is understandable you will still continue to prescribe finasteride under these conditions, do you plan on informing your patients of the reported risks up front so that they can make a properly informed decision?