In The News

Well-Done Meat Consumption May Increase Prostate Cancer Risk
Research into the dietary habits of about a thousand men from the Cleveland area has found that a high consumption of meats, especially of red meat prepared by grilling, is positively associated with an increased risk of developing aggressive prostate cancer. This particular study, which was led by Dr. John Witte of the University of California, San Francisco (UCSF), has a number of limitations, but it does add support to other investigations connecting meat consumption with cancer risk.

Toronto researchers speculate regarding a link between prostate cancer and oral contraceptive use
Very preliminary and speculative research, designed to spark further inquires, suggests that there may be a connection between oral contraceptive use and rising rates of prostate cancer. One theory is that the widespread use of birth-control pills in various populations may result in a higher level of estrogen in the environment, which might, in turn, increase prostate cancer risk.

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Prostate Cancer Risk and 5a-Reductase Inhibitors

6/13/2011

Last week, another voice was added to the ongoing discussion about the benefits and risks of a class of drugs called 5-alpha reductase inhibitors. These drugs (e.g., dutasteride and finasteride) have been used to treat benign prostatic hyperplasia (BPH) for years, but, recently, their possible role in prostate cancer prevention has been studied and debated.

Evidence suggests that men taking 5-alpha reductase inhibitors have about a 24 to 25 per cent reduced risk of developing prostate cancer. (See the PCCN article Prostate Cancer Prevention with Finasteride: New Research, 2008.) However, other research reports that men on these drugs have about a 1 per cent greater incidence of high-grade, advanced tumours.

On June 9, 2011, the United States Food and Drug Administration, which, earlier in the year, refused a request to approve dutasteride and finasteride for use in preventing prostate cancer, issued a safety alert about these drugs.

The Warnings and Precautions section of the labels for the 5-alpha reductase inhibitor (5-ARI) class of drugs has been revised to include new safety information about the increased risk of being diagnosed with a more serious form of prostate cancer (high-grade prostate cancer).
This risk appears to be low, but healthcare professionals should be aware of this safety information, and weigh the known benefits against the potential risks when deciding to start or continue treatment with 5-ARIs in men.
5-ARIs may increase the risk of high-grade prostate cancer.
5-ARIs are not approved for the prevention of prostate cancer.

Although the FDA describes the risk as “low” and only potential (i.e., “5-ARIs may increase the risk”), some individuals involved in prostate cancer treatment are concerned that the new warning presents a less than balanced view of the relation between 5-ARI drugs and prostate cancer prevention. According to Prostate Cancer International, “We are concerned that the FDA has lost sight of the risk-benefit ratio associated with cancer prevention for men at high risk of prostate cancer in coming to the conclusions it has reached.” (See this article.)

Others consider the warning fair. Dr. Anthony D’Amico, chief of genitourinary radiation oncology at Brigham and Women’s Hospital in Boston is one of them: “I think that the warning is appropriate. The risk is very small, but not zero.” He continues, “"You have to weigh the 24 per cent reduction against the 1 per cent increased incidence of high-grade disease."