Unknown to many, prostate cancer — unlike most cancers — isn’t a killer disease and new findings show that a drug may help slow it’s growth, already slow to start with.
Prostate cancer is a rare cancer for men younger than 50 years old, notes the National Cancer Institute, which also points out that the actual lifetime risk of dying from prostate cancer is only 2.8 percent and most deaths occur in men who are over 75 years old.
Dr. Bruce Roth, oncology specialist at the Washington University in St. Louis, Missouri, agrees. Prostate cancer patients are more likely to die of more common causes like stroke or heart attack, he says.
Clearly, prostate cancer patients are not destined to die from it and it’s not even expected to shorten their lives, health experts say. In fact, for most men diagnosed with it, the cancer is growing so slowly, leading doctors to advise men not to leap into aggressive treatments, but to take a “watch and wait” approach.
But try telling that to a man diagnosed with prostate cancer.
“These are people who never sleep again until they get some therapy,” says Dr. Roth. Being men, most patients don’t feel comfortable doing nothing about their cancer. So they go ahead and act: an October 2011 U.S. Preventive Services Task Force (USPSTF) report found that about 90 percent of men diagnosed with prostate cancer choose to go through early treatment with surgery, radiation or hormone therapy.
But these radiation therapy or surgery lead to erectile dysfunction, incontinence, and difficulty urinating and controlling bowel functions—troubling and life-changing side effects that affect up to 30 percent of all men who undergo these treatments.
What’s worse, it turns out that many of these men don’t need treatment after all: a European study analyzed by the USPSTF found that overdiagnosis of prostate cancer was at a very high 50 percent rate.
The good news is that a recent Canadian study shows that, for slow-growing prostate tumors, the drug dutasteride can help make the “watch and wait” more bearable.
Dutasteride, the study shows, may help slow the growth of prostate cancer tumors.
Slows prostate tumor growth
Currently, dutasteride (commonly sold under the brand name Avodart) is used to shrink enlarged prostates. But the new study shows that it also slows the growth of early stage prostate cancer, eliminating the need for aggressive treatment in men with low-risk prostate cancer.
Even better, in the final check done by researchers three years after the men were first recruited into the study, one-sixth of the 300 participants had biopsies that showed absolutely no sign of the cancer
For the study, published Jan. 23 in the journal The Lancet, Canadian researchers followed 300 men, 48 to 82 years old, with low risk prostate cancer being watched actively by their doctors.
Half the men were given a daily placebo, while the other half took 0.5 mg of dutasteride a day for three years, the study’s duration.
The men then underwent biopsies at 18 months and three years later to measure their disease progression. The researchers found that more cancer patients that received dutasteride improved at a higher rate than those given a placebo:
• 48 percent of those given the placebo experienced disease progression
• 38 per cent of the men receiving dutasteride experienced disease progression
Additionally, men treated with dutasteride were more likely to have no cancer detected in their final biopsy. In 50 of the men on the dutasteride group, doctors could find no cancer, compared to 31 men in the placebo group.
The study doesn’t mean that the drug saves lives, since there were no prostate cancer-related deaths during the study, nor were there any instances of disease spread.
But at best, the study means that anxious men diagnosed with prostate cancer can take action without putting themselves at risk for impotence and incontinence—and men taking the medication did report less anxiety in questionnaires throughout the study, compared with those given placebo.
“This drug may not save a life, but it will prevent men whose cancer will pose no long-term risk, stave off surgery or radiation or treatment with side effects,” says the study’s lead investigator, Dr. Neil Fleshner of Princess Margaret Hospital and the University of Toronto in Canada.