Designed to interfere with the body's ability to uptake testosterone and other male hormones, finasteride was offered to half the almost 19,000 men over the age of 55 who participated in the seven-year study.
At the study's start, all the men screened as "normal" following digital rectal exams. As well, all had registered low-scoring prostate-specific antigen (PSA) levels. An elevated level of PSA in the blood is an indication of prostate cancer.
Yearly digital rectal exams and PSA screenings revealed that almost 25 percent of the men on placebo went on to develop prostate cancer. However, just a little over 18 percent of those taking finasteride got the disease.
Fleshner and his associates noted, however, that most of the cancer cases prevented appeared to be of the early stage, low-grade variety. More serious, higher-grade disease actually appeared to become more common among patients taking finasteride. This raises concern that the medication might actually hasten disease progression, the Canadian group cautioned.
Nevertheless, their review concluded that finasteride might, in the near future, become an effective prevention tool for men with a strong family history of the disease.
Additional studies are currently under way to explore the benefits of newer hormone manipulation drugs, they noted, including the 5ARI drug dutasteride and the selective estrogen receptor modifier toremifene. Results should be available in a few years.
Meanwhile, the Canadian team also uncovered evidence suggesting that limiting fat in the diet might also reduce prostate cancer risk. Various studies have highlighted unhealthful connections between fat and pesticide exposure, testosterone level increases, and the rise of oxidative stress -- all of which seem to contribute to prostate disease risk.
By contrast, evide
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