Information about Finesteride to Prevent Prostate Cancer
Finasteride (Proscar), which is used to treat benign prostatic hyperplasia (BPH), has been studied as a potential preventive agent in prostate cancer. In the landmark Prostate Cancer Prevention Trial (PCPT), investigators reported a lower incidence of prostate cancer among Proscar users; 18 percent of the men taking Proscar were diagnosed with prostate cancer, compared with 24 percent of men taking a placebo. However, it is not clear whether the reduction occurred because Proscar actually prevents prostate cancer or if it simply lowers PSA levels.
In the PCPT, men who took Proscar were less likely to undergo biopsy because of lower PSA levels. Thus, Proscar may just prevent a man from knowing that he has the disease.
The development of aggressive tumors (Gleason score of 7 to 10) has been another concern. Aggressive tumors were diagnosed in 6 percent of the participants in the Proscar group compared with 5 percent of the placebo group. Because of the potentially increased risk of developing an aggressive tumor, some physicians are reluctant to prescribe Proscar solely to prevent prostate cancer.
Nevertheless, the Urology Care Foundation (formerly the American Urological Association [AUA]) currently recommends that asymptomatic men with a PSA level of 3 ng/mL or lower who are regularly screened with a PSA test discuss with their doctor the risks and benefits of using Proscar for prostate cancer prevention.
Other drugs have also been investigated for prostate cancer prevention but none has proven to be effective.