February 24, 2009
Reuters

Experts Promote Baldness Drug for Prostate Cancer

By Will Dunham

Millions of healthy men 55 and older should consider taking finasteride, a drug used to treat prostate enlargement symptoms and baldness, to prevent prostate cancer, two top U.S. medical groups said on Tuesday.

Healthy men who are screened regularly and have no symptoms of prostate cancer should discuss with a doctor the possibility of taking a finasteride pill daily to try to ward off the disease, the groups recommended.

The American Society of Clinical Oncology and American Urological Association recommendations said medical studies show the risk of prostate cancer drops by about 25 percent among men taking the drug.

Finasteride is a type of drug called a 5-alpha reductase inhibitor and is available generically to treat urinary problems caused by enlargement of the prostate. Merck and Co sells it as the baldness remedy Propecia. It also was sold by Merck as Proscar to treat enlargement of the prostate before it became available generically.

Finasteride lowers the level of a hormone that can contribute to the growth of prostate cancer.

The studies also set aside earlier worries the drug in some men might promote aggressive prostate cancer, the groups said.

The recommendations were based on evidence in 15 studies, the best known of which was published in the New England Journal of Medicine in 2003.

Dr. Barnett Kramer, a disease prevention specialist at the U.S. National Institutes of Health and co-chairman of the panel that drafted the recommendations, said taking the drug to prevent the disease could cost more than $1,000 a year.

Kramer said 71 men would need to take the drug for seven years for one of those men to avoid getting prostate cancer.

Prostate cancer is the second most-commonly diagnosed cancer in men worldwide and kills about 254,000 a year.

Kramer said studies have indicated the drug may cause side effects such as sexual impotence and reduced sexual desire.

"I think it's a legitimate intervention just like tamoxifen has been proven to decrease the risk of breast cancer in women at high risk of breast cancer," he told reporters.

"Would I be comfortable if a man chooses to take it after a discussion (with a doctor)? ... I would. Would I be comfortable if the next man decided against it? Absolutely," Kramer added.

Dr. Howard Sandler of Cedars-Sinai Medical Center in Los Angeles, speaking for the American Society of Clinical Oncology, some men may want to use it on a trial basis.

"If I tried the medication for a month or two and I got some side effects, then for me personally the benefit wouldn't be worth the risk," Sandler said.

On the other hand, if it caused no side effects and might cut the risk of prostate cancer, "I might sleep easier at night," Sandler said. Asked whether he personally planned to take it, Sandler said, "I haven't made up my mind yet."

Dr. Otis Brawley, chief medical officer of the American Cancer Society, said taking the drug for prostate cancer prevention is a "reasonable option" although his organization did not make such a recommendation.

"It's important to note that thus far, there is no conclusive evidence that using finasteride can reduce the risk of death from prostate cancer. It will likely take many more years before we know the answer to that question," Brawley said by e-mail. (Editing by Maggie Fox and Eric Walsh)