Doctors Back Wider Consideration of Prostate Drug


For the first time, leading medical groups are advising millions
of healthy men who are regularly screened for prostate cancer to
consider taking a drug to prevent the disease.

The advice stops short of saying men should take the drug
finasteride, sold in generic form and as Proscar. It is already
widely used for urinary problems from enlarged prostates as men

However, it has not been widely prescribed as a cancer
preventive, and it may carry some risks. The new guidance tells men
to talk to their doctors and decide for themselves if the good
outweighs the bad.

This advice is bound to be confusing, doctors admit. For one
thing, it doesn't apply to men who choose not to have screening
with PSA blood tests, which no major medical groups recommend.

In men who are regularly screened, finasteride can cut the odds
of being diagnosed with prostate cancer by about 25 percent.

he ought to have the benefits of a discussion" about taking the
scientist and one of the authors of the new guidelines.

They were published in two medical journals and discussed in a
news briefing Tuesday in connection with a cancer conference in
Florida. They were written by doctors with American Society of
Clinical Oncology and the American Urological Association.

cancer, 71 men would have to take the drug for seven years -
another reason this is an individual decision, doctors say.

"There probably would be millions of different attitudes about
occur," said Dr. Howard Sandler, of Cedars-Sinai Medical Center in
Los Angeles.

About 186,000 American men this year will be told they have
cancer of the prostate. The disease often is diagnosed from a
screening saves lives - the reason no major cancer groups recommend

cancer is found. It usually grows so slowly it is not
sexual or bladder control problems.

"We still don't know if screening and aggressive treatment is a
good thing," but if men are getting PSA tests, taking finasteride
is reasonable, said the American Cancer Society's chief medical
officer, Dr. Otis Brawley.

Finasteride shrinks the prostate and curbs testosterone, a
hormone that helps cancer grow. It's already used for urinary
problems, and at a lower dose, it's sold as the baldness drug

whole class of drugs but for now, doctors are focused on

That's because it's the only one shown to prevent cancer so far.
aggressive tumors.

More study found that that wasn't the case. It was just that the
tumors were more easy to detect among men taking the drug because
it helped reduce prostate size.

The new advice to consider finasteride "is long overdue," said
men are given a full picture of the drug's effects, "it's not a
tough sell," he said.

Finasteride has been linked to lower sexual desire and
those were problems for most who weren't taking the drug as well.
Finasteride also gave benefits: fewer urinary problems and less

"The overall quality of life was identical," and most side

Three of the 15 guideline writers have consulted for Merck &

The advice is "aimed at people like me 10 years ago," said
represented patients on the guidelines panel.

"If I had heard there was a possibility of preventing the
disease, it certainly would have captured my interest," he said.
But the potential risk of aggressive tumors can't be ruled out, so
doctors owe men a frank talk, he said.

having urinary problems. When he heard the drug might prevent
cancer, it sealed his decision.

"If it's a possibility of giving me a longer life, I want
that," he said.
On the Net:
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