Chemoprevention of prostate cancer.
Prostate cancer is an appropriate target for primary chemoprevention because of its ubiquity, disease-related mortality, treatment-related morbidity, and long latency period. The PCPT and REDUCE trials demonstrate that this cancer can be prevented by a relatively nontoxic oral pharmacologic agent (5alpha-reductase inhibitors). Evidence from the SELECT trial argues against the recommendation of the use of vitamins and micronutrients as chemoprevention of prostate cancer. Dietary modification may substantially alter a man's risk of prostate cancer, but the specific dietary manipulations that are necessary are poorly defined and these may need to be instituted in early adulthood to be successful. 5alpha-reductase inhibitors represent an effective primary prevention strategy, and these agents should be used more liberally for the prevention of prostate cancer, particularly in high-risk patients.
Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk Q10-1, Cleveland, OH 44195-0001, USA. stephea2@ccf.org
Andrew J
AJ
Stephenson
Robert
R
Abouassaly
Eric A
EA
Klein
D058891:5-alpha Reductase Inhibitors; D001378:Azasteroids / Q000627:therapeutic use; D018890:Chemoprevention; D000068538:Dutasteride; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D018120:Finasteride / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011322:Primary Prevention; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000517:prevention & control*; D012307:Risk Factors
D058891:5-alpha Reductase Inhibitors; D001378:Azasteroids; D004791:Enzyme Inhibitors; D018120:Finasteride; D000068538:Dutasteride