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Dutasteride (Avodart) lowers prostate cancer risk

Avodart is an off-label treatment for male pattern hair loss because it lowers DHT, the body's 'trigger' which causes hair follicles to miniaturize.  Like finasteride, dutasteride has been shown to lower the risk of prostate cancer.  

April 28, 2009 (Chicago, Illinois) — Results from the first-ever study of chemoprevention in prostate cancer show that dutasteride (Avodart, GlaxoSmithKline) lowers the risk for prostate cancer by a significant 23%, with risk for high-grade tumors reduced in particular, investigators reported here at the American Urological Association 104th Annual Scientific Meeting.

The Reduction by Dutasteride of Prostate Cancer (REDUCE) trial is a 4-year, international, randomized placebo-controlled trial of 8200 men from 50 to 75 years with elevated prostate-specific antigen (PSA) levels and a negative prostate biopsy at baseline. Baseline PSA levels ranged from 2.5 to 10.0 ng/mL (median, 5.9 ng/mL).

Patients were randomized to dutasteride, a dihydrotestosterone 5-alpha reductase inhibitor, 0.5 mg daily, or placebo. PSA levels were measured biennially for 4 years, and prostate biopsies were conducted at 2 and 4 years.

"There is currently no approved treatment for risk reduction in prostate cancer," lead investigator Gerald Andriole, MD, professor and chief of urology at Washington University in St. Louis, Missouri, told meeting attendees when presenting the REDUCE findings.

"After 4 years, there was an absolute risk reduction of 22.5% and a relative risk reduction of 23%," Dr. Andriole announced. There were 659 cases of prostate cancer in the dutasteride group and 857 cases in the placebo group.

The incidence of cancer by year 2 was 13.4% with dutasteride and 17.2% with placebo. By year 4, the incidence was 9.1% with dutasteride and 11.8% with placebo.

"Despite an uneven prevalence of cancer at baseline, there was still a significant 23% reduction in risk," Dr. Andriole said.

"Risk was most markedly reduced in the numbers of high-grade tumors, with absolutely no increase in incidence," he added.

"It could be that dutasteride shrinks the prostate and thereby shrinks the tumors, but it also appears that dutasteride has an effect in high-grade tumor cells in particular, through both type 1 and type 2 5-alpha reductase inhibitors," Dr. Andriole said. Type 1 receptor inhibition has a pronounced effect in high-grade tumor cells. Finasteride acts only on type 2 5-alpha reductase inhibitors.

"I would recommend chemoprevention for high-risk men based on these results. It is certainly enough to convince me. I would take it," Dr. Andriole told Medscape Urology. "Any man who is at high-risk because of age, rectal exam, and PSA level . . . or has other factors, such as a high [body mass index], a family history, or other reasons for a risk of prostate cancer greater than 30% in the next 4 years is a candidate in my book."

"Isn't it possible that the PSA doesn't rise until the prostate is filled with high-grade cells, making the cancer more difficult to treat at that point?" asked William J. Catalona, MD, from the Department of Urology at Northwestern Feinberg School of Medicine in Chicago, Illinois.

"I understand the concern, but happily, the data do not support that," Dr. Andriole responded.

"Hormonal therapy is never curative," Dr. Catalona pointed out. "How long will the effects of dutasteride last?"

Dr. Andriole agreed that the drug's effects will not be permanent. He emphasized that there was no increase in the incidence of high-grade tumors, "and these tumors with Gleason scores of 8, 9, and 10 are killers," he said. "In addition, dutasteride enhances the ability of PSA [testing] to detect cancers. It makes PSA a better test," he asserted.

REDUCE was funded by GlaxoSmithKline, the maker of Avodart. Dr. Catalona has disclosed no relevant financial relationships.

American Urological Association 104th Annual Scientific Meeting: Late Breaking Abstract 1. Partial results presented April 27, 2009; full results presented April 28, 2009.

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Authors and Disclosures

Journalist

Martha Kerr

Martha Kerr is a freelance writer for Medscape.

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Information

Authors and Disclosures

Martha Kerr
Martha Kerr is a freelance writer for Medscape.


Zerona on "The Doctors"- a non-invasive liposuction alternative

"The Doctors" patient, Christine, lost 7 inches in two weeks from her Zerona treatments.  Zerona is a non-surgical liposuction alternative that shrinks unwanted fat.  Watch the video above, click to read Dr. Orden's blog on Zerona below or contact doctorb@baumanmedical.com for more information or to schedule your Zerona treatment regimen.

Visit Dr. Orden's blog on Zerona

http://www.thedoctorstv.com/DrOrdon/posts/2682-Zerona-Non-Invasive-Liposuction

Contact Bauman Medical Group for Zerona Treatments


Dr. Bauman to lecture at Anti-Aging Conference: A4M Orlando 2009

Dr. Bauman to lecture at the World Congress on Anti-Aging Medicine

Dr. Alan Bauman, founder and medical director of Bauman Medical Group, will be presenting on the latest techinques in the treatment of hair loss at the American Academy of Anti-Aging Conference in Orlando, April 23, 2009 at 2pm.  The lecture, "Hair Restoration: Maintaining and Restoring the Aging 'Frame' of the Face" will include an overview of diagnostic tools (genetic testing and scalp microscopy), non-invasive medical treatments, prescription medications, 'off-label' options,  low level laser therapy, nutritional modification as well as the latest artistic hair transplant techniques (no-scalpel/no-stitch "FUE" and NeoGraft procedures)--including eyelash transplantation, and more.  For more information, visit http://www.anti-agingevents.com/orlando/.   See you there! 

Dr. Bauman is one of approximately 100 board-certified Hair Restoration Physicians worldwide and is recommended by the American Hair Loss Association.


Dr. Bauman to receive Leadership Award from Boca Raton Chamber of Commerce

Greater Boca Raton Chamber of Commerce Boca Raton, FL—Each year, the Greater Boca Raton Chamber of Commerce recognizes businesses and business people that exemplify the highest standards of leadership in the community and strong philanthropic involvement.  Dr. Alan Bauman has been a member of the chamber for over ten years.  This year, Dr. Bauman is proud to be amongst those honored at the 2009 Greater Boca Raton Chamber of Commerce Awards Luncheon (Boca Raton Resort and Club | 501 E Camino Real Boca Raton | Friday, May 15th 2009 | 12noon-1:30pm)  as the recipient of the 2009 Small Business Leader of the Year award.  Dr. Bauman is the first physician to ever receive this honor.  For more information or tickets to the event, please visit http://www.bocaratonchamber.org.  For those who can attend, we all look forward to seeing you there!