Saving 175 Jumbo Jets Full of Men

Prostate cancer risks lower and mortality rates the same in those taking finasteride

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) The results were exciting — a study revealed that a medication lowered prostate cancer risks by nearly 25 percent. But researchers found that men taking the medication who did develop prostate cancer tended to have a more aggressive disease. The medication is called finasteride. It’s sold under the brand names Propecia and Proscar and is used to treat prostate enlargement and male baldness.

A new 18-year follow-up to the original Prostate Cancer Prevention Trial has discovered that finasteride reduces risks for prostate cancer by about 30 percent.

The new study found that men taking the medication lived just as long as the men who didn’t take finesteride. 

Altogether, the medication reduced prostate cancer risks and didn't affect lifespan.

"Ask your doctor about ways you can prevent cancer."

Ian M. Thompson, Jr., MD, director of the CTRC at The University of Texas Health Science Center at San Antonio, led this new study.

With simple math, Dr. Thompson suggests that 30 percent of the 238,500 men diagnosed annually with prostate cancer — more than 71,000 men — could be saved from having to deal with prostate cancer.

“That's more than 175 jumbo jets full of men who won't get cancer, who won't face treatments with side effects like sexual dysfunction,” Dr. Thompson said in a press release announcing the findings.

The authors wrote that they conducted the analysis to see if there was an increased risk of death among men taking finasteride, "...since such an increase would be a potentially accurate indicator of an increase in the risk of high-grade (and hence more lethal) cancer."

The original trial studying finasteride began in 1993 and included 18,800 men. In a nutshell, that study found that 10.5 percent of men in the treatment group developed prostate cancer, compared with 14.9 percent of the men in the placebo (sham pill) group.

The 10-year survival rate was 83 percent in the finasteride group and 80.9 percent among men in the placebo group.

But 3.5 percent of men in the finesteride group had high-grade cancer versus 3 percent of men in the untreated group.

Based on these findings, the US Food and Drug Administration (FDA) in 2011 did not approve finasteride for use as medicine to prevent prostate cancer.

In the current follow-up study, the researchers found that the 15-year survival rates were essentially the same — 78 percent of men taking finasteride and 78.2 percent of the men who took no medication were still alive after 15 years.

“This is truly the case of an ounce of prevention is worth a pound of cure,” E. David Crawford, MD, professor of surgery, urology and radiation oncology, and head of the Section of Urologic Oncology at the University of Colorado Health Sciences Center (UCHSC) in Denver, told dailyRx News.

“Even though the mortality rate was not reduced, the morbidity of treatment certainly would be. As pointed out by Dr. Thompson, nearly 71,000 men could be saved from the risks of treatment,” said Dr. Crawford, who was not involved in the study.

He added that a large trial showed another medicine — dutasteride (brand name Avodart) — also reduced the incidence of prostate cancer, but did not receive FDA approval as a prostate cancer prevention medication either.

Dr. Crawford concluded, “The exciting results of this trial will be more theoretical than real. Since neither drugs are approved, it is doubtful that there will be widespread usage.“

A 30-day supply of 5-milligrams of generic finasteride costs about $15.

This study was published August 14 in The New England Journal of Medicine.

The research was funded by the National Cancer Institute.

Two of the authors reported having financial ties to pharmaceutical companies.

Review Date: 
August 14, 2013
Last Updated:
August 15, 2013