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Prostate Cancer Risk Reduction by Chemoprevention
Book chapter

Prostate Cancer Risk Reduction by Chemoprevention

Kenneth G Nepple, Adam S Kibel and Gerald L Andriole
Management of Prostate Cancer, pp.143-152
Current Clinical Urology, Humana Press
07/10/2012
DOI: 10.1007/978-1-60761-259-9_9

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Abstract

Prostate cancer is a leading cause of morbidity and mortality with significant treatment associated complications. Chemoprevention could potentially decrease the morbidity and mortality from the disease. Prostate cancer has been an attractive target for chemoprevention. Research has primarily focused on 5 alpha reductase inhibitors and nutrients including three large randomized placebo controlled trials published between 2003 and 2010 with a total of 61,144 patients. The Prostate Cancer Prevention Trial examined the utility of finasteride in low risk men with no prior prostate biopsy. They reported a 24.4 % reduction in overall prostate cancer risk (18.4 % vs. 24.4 %), but an increased risk for high grade tumors. Subsequent analysis has demonstrated this increased risk for high grade disease is likely an artifact. The Reduction by Dutasteride of Prostate Cancer Events trial of dutasteride in a higher risk group of men with a negative baseline biopsy found a 22.8 % relative risk reduction in prostate cancer (19.9 % vs. 25.1 %) with no increase in high grade prostate cancer. With respect to nutrient use, the Selenium and Vitamin E Cancer Prevention Trial found no favorable effect of selenium or vitamin E on prostate cancer prevention. In summary, the data are strongest for the use of 5 alpha reductase inhibitor dutasteride in prostate cancer chemoprevention of high risk patients. Conclusive evidence for the benefit of nutrients or vitamins is lacking.
 Prostate Biopsy Prostate Cancer Prostate Cancer Mortality High Grade Prostatic Intraepithelial Neoplasia Lower Urinary Tract Symptom

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