Finasteride may aid early diagnosis of aggressive prostate Ca

Finasteride (Proscar) appears to raise the odds that physicians will find fast-growing prostate cancers early, suggests a study from the Southwest Oncology Group.

“It appears that a man concerned about prostate cancer risk who is having a PSA test on a regular basis will not only reduce his risk of prostate cancer if he takes finasteride, but will help find the cancers that pose the highest risk,” said senior author Ian M. Thompson, MD, of the University of Texas Health Science Center in San Antonio.

“Finasteride makes the PSA test perform better so we can find the cancer earlier. Our current study also shows that by shrinking the prostate gland, finasteride makes a biopsy more sensitive for any cancers that are present.”

The study, an analysis of data from the Prostate Cancer Prevention Trial (PCPT), appears to lessen fears that finasteride may have led to a higher incidence of aggressive prostate cancer in PCPT subjects, Dr. Thompson and colleagues reported in the Journal of the National Cancer Institute (online edition ahead of print publication Sept. 18).

With several studies allaying concerns about the drug’s possible drawbacks, including concerns about sexual dysfunction, Dr. Thompson believes men should be told routinely about the potential benefits of finasteride when they come to the physician’s office for a PSA test.

The researchers did not find evidence that the drug caused changes in tumor composition that might contribute to aggressive cancer, although they did not entirely rule out the possibility that finasteride may have led to high-grade prostate cancer in some men in the study.

“The results suggest that high-grade cancer was detected earlier and was less extensive in the finasteride group than in the placebo group,” the researchers said.