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Prostate Cancer Prevention

Men over the age of 50 pay attention. 

Avodart and Proscar are drugs in a class known as “5-ARIs.”

This class of drugs was developed to treat enlarged prostate (also known as BPH, or benign prostatic hyperplasia). 

In a 2010 New England Journal of Medicine study, about 3,300 men at high risk of prostate cancer took Avodart for four years. A second group of men — also at high risk — took a placebo.

Compared to placebo, the relative risk of any level of prostate cancer was reduced by nearly 23 percent in the Avodart group.

Sounds pretty good, right? I mean…based purely on that number, you wouldn’t blink if your doctor encouraged you to take a 5-ARI if you’re at high risk of prostate cancer. And keep in mind that every man between the ages of 50 and 75 is considered high risk. 

Patrick Walsh, M.D., is a Professor of Urology at Baltimore’s Johns Hopkins School of Medicine where he served as Urologist-in-Chief for 30 years. In an editorial he wrote that appears in the same NEJM issue as the Avodart study, Dr. Walsh points out that Avodart and Proscar, “do not prevent prostate cancer but merely temporarily shrink tumors that have a low potential for being lethal, and they do not reduce the risk of a positive biopsy in patients who have an elevated PSA level.” 

“Men will believe that it prevents cancer, will be pleased that their PSA levels fall, and will not understand the potential danger of undiagnosed high-grade disease.” Speaking specifically about the Avodart study, he said the results showed, “there was a 23% reduction in low-grade tumors that the patients would never have known they had. Does this sound like an indication to take a pill with sexual side effects that costs $4 a day?” 

In the NEJM study, sexual dysfunction was higher in the Avodart group, and — even more important — subjects in that group were nearly TWICE as likely to experience heart failure compared to placebo.

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