Data re-analysis shows drug finasteride reduces risk for most prosta...( NEW YORK (May 20 2008) -- A re-analy...),Health

NEW YORK (May 20, 2008) -- A re-analysis of data from the landmark Prostate Cancer Prevention Trial (PCPT) finds that finasteride reduces the risk for prostate cancer without boosting the odds of aggressive tumors.

PCPT, which involved more than 18,000 men 55 years of age or over, was stopped early in June 2003 because researchers noted that while it reduced prostate cancer in men taking finasteride (Proscar) by up to 25 percent, men taking finasteride also appeared to have more aggressive prostate tumors if and when they did develop the disease.

That caused some experts to worry that finasteride was encouraging higher-grade cancers.

But a new analysis led by researchers at NewYork-Presbyterian Hospital/Weill Cornell Medical Center should lay that worry to rest.

"Finasteride has long been used by doctors to treat benign enlarged prostate -- it shrinks the prostate. So when we accounted for this shrinkage in prostate volume, the disparity in tumor aggressiveness between the finasteride and placebo groups vanished," says study lead author Dr. Steven A. Kaplan, professor of urology at Weill Cornell Medical College and a urologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

He and his colleagues will present their findings Tuesday, May 20, at the annual meeting of the American Urological Association, in Orlando.

Physicians grade the aggressiveness of prostate tumors on what's called the Gleason Score -- a grading of tumor characteristics, with scores ranging from 2 to 10 (10 indicating the most highly aggressive cancers). "After their initial analysis, the PCPT investigators discovered that men taking finasteride had fewer prostate cancers overall, but a higher incidence of grades 7, 8, 9 and 10 cancers," Dr. Kaplan explains.

This was worrying, since it is higher-grade, potentially metastatic prostate cancers that are the real cause for clinical concern. "Lower-grade cancers are oft
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