TUESDAY, Jan. 24 (HealthDay News) -- New research suggests that
Avodart, a drug used to treat an enlarged prostate gland, may help
slow the progression of early stage prostate cancer, reducing the
need for aggressive treatment in some men.
Prostate cancer can grow and spread slowly, which is why some
men are urged to engage in so-called watchful waiting when the
cancer is first diagnosed. Avodart (dutasteride) may help such men
feel comfortable with surveillance as opposed to radical treatment,
the researchers noted.
"The concept of active surveillance is gaining traction in most parts of the world," said study author Dr. Neil E. Fleshner, head of the division of urology at the Princess Margaret Hospital in Toronto. Still, some men are uncomfortable with doing nothing in the face of a cancer diagnosis, he said. "By using this drug, we can improve the proportion of men who remain committed to the surveillance."
The findings are published online Jan. 25 in
The Lancet.
According to the U.S. National Cancer Institute, one out of
every six men in the United States will develop prostate cancer in
his lifetime. But because many of those cancers are low-grade, most
will die of something else.
Avodart belongs to a class of drugs called 5-alpha reductase
inhibitors. These drugs work by interfering with the effects of
certain male hormones on the prostate. In the three-year study,
prostate cancer progressed in 38 percent of 144 men with early
prostate cancer who were treated with Avodart and 48 percent of the
145 men who received a placebo.
Men seem less anxious about the cancer diagnosis when they are
doing something more proactive, Fleshner said. "The drug augments
active surveillance and avoids most of the side effects associated
with surgery and radiation," he said. Prostate removal surgery
and/or radiation can lead to impotence and incontinence, he
said.
The medication does have side effects, however, including
reversible breast enlargement and tenderness and some sexual
dysfunction.
"We know that we are over-treating prostate cancer," said Dr. Louis Potters, chairman of radiation medicine at North Shore University Hospital and Long Island Jewish Medical Center in Manhasset, N.Y.
"In the U.S., patients have a tendency to hear the word 'cancer,' and want to treat it right away," he said. "In these men with early prostate cancer, we can now say, 'Let's put you on this medication, and see what happens over the next couple of months.'"
However, some experts have concerns about 5-alpha reductase
inhibitors. The U.S. Food and Drug Administration recently issued a
warning that men who take these drugs to treat enlarged prostate
glands may be at increased risk for high-grade prostate cancer.
Dr. Ryan Terlecki, an assistant professor of urology at Wake
Forest Baptist Medical Center in Winston-Salem, N.C., said this may
dampen enthusiasm for use of the drug to treat cancer.
"The overall role that these medications will play for urologists will decrease," Terlecki said. Doctors will likely begin looking toward noninvasive and/or non-medical treatments such as the use of thermal heat to cope with some of the symptoms of prostate conditions, he added.
More information
Learn more about prostate cancer at the
American Cancer Society.