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Study Revives Debate on Prostate Drug
Date:3/31/2010

Experts disagree on whether medication cuts cancer risk

WEDNESDAY, March 31 (HealthDay News) -- A new study to determine whether a drug prescribed to fight the problems of an enlarged prostate gland can also reduce the risk of prostate cancer promises to prolong a debate that started with an earlier study of a similar drug.

The renewed debate plays out in the April 1 issue of the New England Journal of Medicine, which carries not only a report saying that the drug dutasteride (Avodart) may reduce the risk for prostate cancer but also an editorial that counters the upbeat conclusions of the study point by point.

The results of the four-year study of the effect of Avodart on prostate -- financed by Glaxo, which markets the drug -- seem to mirror those of a 19,000-participant study in 2003 of finasteride (Propecia), which found a 25 percent lower incidence of prostate cancer among men who took that drug than among those who took a placebo.

But that study has been controversial ever since, partly because initial analyses -- later discredited -- found a higher percentage of aggressive cancers in men taking finasteride.

The new study is different, said Dr. Gerald L. Andriole Jr., chief of urologic surgery at Washington University in St. Louis and lead author of the latest report. Though the two drugs act in the same way, by inhibiting enzymes that cause enlargement of the prostate, Avodart inhibits two such enzymes and Propecia only one, Andriole explained.

"And this trial evaluated men at high risk of prostate cancer," he said. "Cancers in this group of men are likely to be more significant."

Risk was evaluated by blood levels of prostate-specific antigen (PSA), which is associated with prostate cancer, and by family history. The study found a 31 percent reduction in prostate cancers in men with a family history of the condition.

Periodic biopsies, or tissue samples, were
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