More Prostate Cancers Might Be Prevented

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By Alan Mozes
HealthDay Reporter
Monday, September 24, 2007; 12:00 AM

MONDAY, Sept. 24 (HealthDay News) -- Prostate cancer prevention studies conducted since the 1990s are poised to revolutionize the field in the next five years, a Canadian analysis concludes.

"I am optimistic that for the coming generation, beginning with men in their 20s and 30s, we will have a viable strategy to decrease the chance of developing prostate cancer later in life," said study lead author Dr. Neil Fleshner.

A professor of surgery, Fleshner heads the division of urology at Princess Margaret Hospital, part of the University Health Network at the University of Toronto.

His team's overview of the last 15 years of prostate cancer prevention research is published in the Nov. 1 issue ofCancer.

According to the U.S. National Cancer Institute (NCI), cancer of the prostate is the most common non-skin cancer among American men. Most patients diagnosed with the disease do not ultimately die of it. However, because of its high prevalence, prostate cancer remains the third biggest cancer killer for men in the Western world.

By age 40, one-third of men have already developed small carcinomas of the prostate, the researchers noted. By age 60, that figure rises to 60 percent, and, in North America, one in seven men will develop prostate cancer at some point in their lives.

But the disease is also often slow-moving, sometimes taking decades to develop from a single prostate cancer cell to advanced-stage illness.

That fact has led to the hope that doctors could intervene in ways that could halt disease progression at an early stage.

One such study reviewed by Fleshner and his colleagues was the Prostate Cancer Prevention Trial (PCPT), overseen by the NCI.

In this instance, NCI researchers looked at the ability of finasteride -- a so-called 5-alpha reductase inhibitor (5ARI) medication -- to impede the growth-promoting impact of hormones such as testosterone on prostate cancer.

Designed to interfere with the body's ability to uptake testosterone and other male hormones, finasteride was offered to half the almost 19,000 men over the age of 55 who participated in the seven-year study.

At the study's start, all the men screened as "normal" following digital rectal exams. As well, all had registered low-scoring prostate-specific antigen (PSA) levels. An elevated level of PSA in the blood is an indication of prostate cancer.


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