Although the number of men starting finasteride grew over a five-year period, the publication of the PCPT trial did not influence their decision. Fifty-seven percent of urologists and 40 percent of primary care physicians said they prescribed finasteride more often; only 2 percent said they had been influenced by the findings in PCPT.
In fact, 64 percent of urologists and 80 percent of primary care physicians never prescribe finasteride for chemoprevention. When asked for reasons for their decision, 55 percent said they were concerned about the risk of high-grade tumors and 52 percent said they did not know it could be used for chemoprevention.
"The use of finasteride for prostate cancer prevention does not appear to be widely endorsed," said Kinsinger. "The concept of chemoprevention is a difficult one for patients and physicians."
At the American Association for Cancer Research 101st Annual Meeting 2010 in Washington, D.C., researchers presented results of the STAR trial, which showed a reduction in breast cancer with raloxifene use. In turn, experts discussed the implications of raloxifene for breast cancer prevention. Scott Lippman, M.D., chair of the Department of Thoracic/Head and Neck Medical Oncology at the University of Texas M. D. Anderson Cancer Center and editor-in-chief of Cancer Prevention Research, and Judy E. Garber, M.D., M.P.H., director of the Cancer Risk and Prevention Program at Dana-Farber Cancer Institute and AACR president-elect, said the public needs to think about agents like raloxifene in the same manner that they would think about statins in heart disease prevention.
Statins revolutionized the treatment of heart disease by driving cholesterol levels down with little to no side effects and thus reducing the risk of cardiovascular disease. Thompson said the statin to chemoprevention analogy is a good one, but presents an important challenge.
"Statins lower heart disease by r
|Contact: Jeremy Moore|
American Association for Cancer Research