8] Two studies have shown that 5-alpha reductase inhibitors
(5ARIs) reduce the risk of prostate cancer.
Reasons for the current stagnation of progress include failure of the Selenium and Vitamin E Cancer Prevention Trial (SELECT) to show preventive activity of selenium and vitamin E; the failure of a high-risk phase III study to show preventive activity of selenized yeast; the refusal of the Food and Drug Administration to approve finasteride for prostate cancer prevention; and uncertainty regarding the long-term effects of treatment with 5-alpha reductase inhibitors
, according to Dr.
20) The current approach for medical management of LUTS associated with BPH depends on the usage of alpha-1 receptor blockers, such as alfuzosin, doxazosin, silodosin, tamsulosin and terazosin or suppression of the hormonal growth of the prostate by the 5-alpha reductase inhibitors
finasteride and dutasteride.
A review of several published reports attribute the higher Gleason scores observed in the groups taking the 5-alpha reductase inhibitors
(Avodart[R] or Proscar[R]) to the fact that it was easier to find high-grade cancers in the shrunken glands of men taking these drugs compared to the much larger glands of men in the placebo group.
The two main classes of BPH drugs: alpha blockers like Flomax and UroXatral, which relax the muscles of the bladder neck and prostate, and 5-alpha reductase inhibitors
like Proscar and Avodart, which lower levels of hormones produced by the prostate.
Men were asked to take one of the 5-alpha reductase inhibitors
or a placebo in a double-blind, randomized, controlled study over a number of years.
The findings suggest that men with early baldness may benefit from routine prostate cancer screening or preventive measures that could include the systematic use of 5-alpha reductase inhibitors
, the researchers wrote (doi:10.
Whilst some symptoms of BPH are successfully addressed by the standard BPH therapies of alpha blockers and 5-alpha reductase inhibitors
, nocturia remains inadequately treated.
Medical treatments for BPH include 5-alpha reductase inhibitors
(5-ARIs), which block the conversion of testosterone to dihydrotestosterone (DHT) via 5-alpha reductase (5-AR).
Using data from the National Health and Nutrition Examination Survey (NHANES) for 2003-2006, the researchers assessed associations between medication use and log-transformed PSA levels in 1,846 men aged 40 years or older who had a serum PSA measurement; did not have a history of prostate cancer, prostatitis, or recent prostate manipulation; and were not taking 5-alpha reductase inhibitors
or hormone therapy.
alpha-blockers, 5-alpha reductase inhibitors
, antimuscarinics) and physiotherapy.
That body of evidence provided proof" that the 5-alpha reductase inhibitors
will decrease the risk of prostate cancer in men being regularly screened for the disease, Dr.