enlarged prostate

Researchers investigated whether treating an enlarged prostate is linked with poorer outcomes in men later found to have prostate cancer.

Enlarged prostates can cause uncomfortable urinary symptoms

An enlarged prostate in men occurs due to an overgrowth of prostate cells. Prostate enlargement occurs naturally as a man ages, affecting as many as 27 million men in the United States. Prostate enlargement is a benign condition and does not spread to other parts of the body.

Getting older, having obesity, and not getting enough physical activity may increase the chance of prostate enlargement. Common signs and symptoms of prostate gland enlargement include frequent or urgent need to urinate, increased frequency of urination at night, difficulty passing urine, and weak or slow urine stream.

This condition is typically treated with a specific group of drugs called 5-α reductase inhibitors (5-ARIs); these include finasteride (Proscar) and dutasteride (Avodart).

5-ARIs delay prostate cancer diagnosis

In a recent study published in JAMA Internal Medicine, a research team from The University of California San Diego, investigated whether pre-diagnostic use of 5-ARIs is linked with poorer outcomes in men who are later diagnosed with prostate cancer.

The researchers examined data from a population-based cohort of over 80,000 patients from the Veterans Affairs San Diego Healthcare System between 2001 and 2015. Among them, about 10.6 % were prescribed 5-ARIs at least one year before a prostate cancer diagnosis.

The researchers found that men who took 5-ARIs drugs were diagnosed with prostate cancer 3.6 years after the first sign of prostate gland enlargement, compared to only 1.4 years for men who were not previously prescribed these drugs. More surprisingly, men taking 5-ARIs also had more advanced disease at diagnosis. They were more likely to have a Gleason score of eight or higher, clinical stage T3 or higher, node-positive, and metastatic disease compared to men who were not taking 5-ARIs.

Written by Man-tik Choy, Ph.D

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Reference: Sarkar, R.R. et al. Association of Treatment With 5α-Reductase Inhibitors With Time to Diagnosis and Mortality in Prostate Cancer. JAMA Internal Medicine, DOI: 10.1001/jamainternmed.2019.0280.

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