title: Risk adapted chemoprevention for prostate cancer: an option?
abstract: A high disease prevalence, the presentation in older age, a frequently slowly progressing course of disease, and high costs make diagnosis and therapy of prostate cancer a special challenge for urologists. Effective prevention of the disease may help to resolve some of the problems mentioned above. Two randomised, controlled studies prove that effective chemoprevention of prostate cancer is possible using 5-α reductase inhibitors (finasteride, dutasteride) (LoE 1) both in individuals at low and those at high risk developing prostate cancer. Furthermore, there is evidence that other compounds, e.g. selective estrogen receptor modulators (SERMs), non-steroidal anti-inflammatory drugs (NSAIDs) and statins might also be effective. This review investigates potential risks and benefits of chemoprevention including a consideration of health economic aspects. The authors conclude that chemoprevention in a high risk cohort using 5-α reductase inhibitors is a viable option and may even be cost effective. In consequence, the options of chemoprevention in prostate cancer should be further explored in an open and unbiased way.
authors: Urologie, Schön Klinik Nürnberg/Fürth, Urologie 24, c/o Europa-Allee 1, 90763, Fürth, Germany, bernd_sd@yahoo.de.
authors: Bernd J
authors: BJ
authors: Schmitz-Dräger
authors: Oliver
authors: O
authors: Schöffski
authors: Michael
authors: M
authors: Marberger
authors: Sevim
authors: S
authors: Sahin
authors: Hans-Peter
authors: HP
authors: Schmid
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018890:Chemoprevention / Q000379:methods*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use
chemical_list: D058891:5-alpha Reductase Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D020845:Selective Estrogen Receptor Modulators