title: The role of 5-alpha-reductase inhibitors in active surveillance.
abstract: OBJECTIVE
  Active surveillance is now considered one of the preferred treatments for men with favorable risk prostate cancer (PCa). Unfortunately, 30-50% of men choosing active surveillance will progress and require therapy. In this context, we will present recent data on the efficacy of 5-alpha-reductase inhibitors (5-ARIs) in secondary prevention among men with low-risk PCa choosing active surveillance.
  
  
  RESULTS
  Two recent studies including a multicenter randomized controlled study demonstrate that 5-ARI may reduce the rate of clinical progression in low-risk PCa.
  
  
  CONCLUSIONS
  5-ARIs may play an important role in secondary prevention in low-risk PCa. These results should be interpreted with caution in view of the recent US Food and Drug Administration recommendation against PCa chemoprevention labeling for 5-ARIs.
authors.affiliation: Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada. sdmargel@gmail.com
authors.forename: David
authors.initials: D
authors.lastname: Margel
authors.forename: Neil
authors.initials: N
authors.lastname: Fleshner
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D018450:Disease Progression; D055088:Early Detection of Cancer; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D018579:Patient Selection; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D013997:Time Factors; D057832:Watchful Waiting
chemical_list: D058891:5-alpha Reductase Inhibitors; D018931:Antineoplastic Agents, Hormonal