Skip to main content
SpringerLink
Log in

The Role of 5α-Reductase Inhibitors (5-ARIs) in Prostate Cancer Chemoprevention

  • Chapter
  • First Online:
Prostate Cancer: A Comprehensive Perspective

  • 2920 Accesses

Abstract

Prostate cancer, due to its high prevalence and long latency period, is an ideal candidate for prevention. Considerable effort has been placed on prevention strategies utilizing 5α-reductase inhibitors (5-ARIs). In this chapter, we will review the rationale and key studies examining the role of these drugs in primary and secondary prevention of prostate cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 229.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Crook JM, Gomez-Iturriaga A, Wallace K, Ma C, Fung S, Alibhai S, Jewett M, Fleshner N. Comparison of health-related quality of life 5 years after SPIRIT: surgical prostatectomy versus interstitial radiation intervention trial. J Clin Oncol. 2011;29:362–8.

    Article  PubMed  Google Scholar 

  2. Sanda MG, Dunn RL, Michalski J, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med. 2008;358(12):1250–61.

    Article  PubMed  CAS  Google Scholar 

  3. Garos S, Kluck A, Aronoff D. Prostate cancer patients and their partners: differences in satisfaction indices and psychological variables. J Sex Med. 2007;4(5):1394–403.

    Article  PubMed  Google Scholar 

  4. Nelson WG, De Marzo AM, Isaacs WB. Prostate cancer. N Engl J Med. 2003;349:366–81.

    Article  PubMed  CAS  Google Scholar 

  5. Thomas LN, Lazier CB, Gupta R, et al. Differential alterations in 5alpha-reductase type 1 and type 2 levels during development and progression of prostate cancer. Prostate. 2005;63:231–9.

    Article  PubMed  CAS  Google Scholar 

  6. Clark RV, Hermann DJ, Cunningham GR, Wilson TH, Morrill BB, Hobbs S. Marked suppression of dihydrotestosterone in men with benign prostatic hyperplasia by dutasteride, a dual 5alpha-reductase inhibitor. J Clin Endocrinol Metab. 2004;89:2179–84.

    Article  PubMed  CAS  Google Scholar 

  7. Sakr WA, Grignon DJ, Crissman JD, et al. High grade prostatic intraepithelial neoplasia (hgpin) and prostatic adenocarcinoma between the ages of 20–69: an autopsy study of 249 cases. In Vivo. 1994;8:439–43.

    PubMed  CAS  Google Scholar 

  8. Thompson IM, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med. 2003;349:215–49.

    Article  PubMed  CAS  Google Scholar 

  9. Wilt T, MacDonald R, Hagerty K, et al. 5-α reductase inhibitors for prostate cancer prevention. Cochrane Database Syst Rev. 2008; 2: Art no.CD007091.

    Google Scholar 

  10. Lucia MS, Epstein JI, Goodman PJ, et al. Finasteride and high-grade prostate cancer in the Prostate Cancer Prevention Trial. J Natl Cancer Inst. 2007;99:1375–83.

    Article  PubMed  CAS  Google Scholar 

  11. Kaplan S, Garvin D, Gilhooly P, et al. Impact of baseline symptom severity on future risk of benign prostatic hyperplasia-related outcomes and long term response to finasteride: The Pless Study Group. Urology. 2000;56:610–6.

    Article  PubMed  CAS  Google Scholar 

  12. McConnell JD, Roehrborn CG, Bautista OM, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003;349:2387–98.

    Article  PubMed  CAS  Google Scholar 

  13. Cohen YC, Liu KS, Heyden NL, et al. Detection bias due to the effect of finasteride on prostate volume: a modeling approach for analysis of the Prostate Cancer Prevention Trial. J Natl Cancer Inst. 2007;99:1366–74.

    Article  PubMed  CAS  Google Scholar 

  14. Talcott JA. Rebalancing ratios and improving impressions: later thoughts from the prostate cancer prevention trial investigators. J Clin Oncol. 2005;23:7388–90.

    Article  PubMed  Google Scholar 

  15. Thompson IM, Chi C, Ankerst DP, et al. Effect of finasteride on the sensitivity of PSA for detecting prostate cancer. J Natl Cancer Inst. 2006;98(16):1128–33.

    Article  PubMed  CAS  Google Scholar 

  16. Andriole GL, et al. Effect of dutasteride on the risk of prostate cancer. N Engl J Med. 2010;362:1192–202.

    Article  PubMed  CAS  Google Scholar 

  17. Kramer BS, Hagerty KL, Justman S, et al. Use of 5-alpha–reductase inhibitors for prostate cancer chemoprevention: American Society of Clinical Oncology/American Urological Association 2008 Clinical Practice Guideline. J Clin Oncol. 2009;27:1502–16.

    Article  PubMed  CAS  Google Scholar 

  18. Finelli A, et al. Impact of 5a-reductase inhibitors on men followed by active surveillance for prostate cancer. Eur Urol. 2011;59:509–14.

    Article  PubMed  CAS  Google Scholar 

  19. Fleshner N, Gomella LG, Cookson MS, Finelli A, Evans A, Taneja SS, Lucia MS, Wolford E, Somerville MC, Rittmaster R, REDEEM Study Group. Delay in the progression of low-risk prostate cancer: rationale and design of the Reduction by Dutasteride of Clinical Progression Events in Expectant Management (REDEEM) trial. Contemp Clin Trials. 2007;28(6):763–9.

    Article  PubMed  CAS  Google Scholar 

  20. Fleshner N, Lucia MS, Melich K, Nandy I, Black L, Rittmaster R. Dutasteride reduces prostate cancer progression and cancer diagnosis on re-biopsy in the REDEEM active surveillance study. Abstract SUO. 2010.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada

    David Margel M.D. & Neil Fleshner M.D.

Authors
  1. David Margel M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Neil Fleshner M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Margel M.D. .

Editor information

Editors and Affiliations

  1. New York Presbyterian Hospital, Brady Urologic Health Center, Weill Cornell Medical Center, East 68th Street 525, New York, 10021, New York, USA

    Ashutosh Tewari

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Margel, D., Fleshner, N. (2013). The Role of 5α-Reductase Inhibitors (5-ARIs) in Prostate Cancer Chemoprevention. In: Tewari, A. (eds) Prostate Cancer: A Comprehensive Perspective. Springer, London. https://doi.org/10.1007/978-1-4471-2864-9_32

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2864-9_32

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2863-2

  • Online ISBN: 978-1-4471-2864-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation