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Anna Wallerstedt, Peter Strom, Henrik Gronberg, Tobias Nordstrom, Martin Eklund
Background: Studies have shown that 5α-reductase inhibitors (5-ARIs) decrease the risk for low-grade prostate cancer (PC), but results are conflicting concerning high-grade PCs. The objective of the present study is to evaluate the association between 5-ARI treatment for lower urinary tract symptoms and the risk for PC. Methods: This is a population-based prospective study on all men age 40 years and older with at least one prostate-specific antigen (PSA) test in Stockholm County from January 2007 until December 2015...
March 14, 2018: Journal of the National Cancer Institute
Tayyar Alp Özkan, Oğuz Özden Cebeci, İbrahim Çevik, Özdal Dillioğlugil
Objective: The incidence of prostate adenocarcinoma (PCa) is increased with the use of prostate-specific antigen (PSA). In the current study, we aimed to investigate the impact of 5- alpha- reductase inhibitors (5-ARI) on pathological progression in patients followed by active surveillance (AS). Material and methods: Records of 69 patients with localized prostate cancer under AS (PSA ≤15 ng/mL, PSAD ≤0.20, ≤cT2c, Gleason sum ≤3+3, the number of cancer positive cores ≤3) were evaluated retrospectively...
March 2018: Turkish Journal of Urology
Eric H Kim, John A Brockman, Gerald L Andriole
Benign prostatic hyperplasia (BPH) is characterized by an enlarged prostate, lower urinary tract symptoms (LUTS), and a decreased urinary flow rate. Common in older men, BPH is a progressive disease that can eventually lead to complications including acute urinary retention (AUR) and the need for BPH-related surgery. Both normal and abnormal prostate growth is driven by the androgen dihydrotestosterone (DHT), which is formed from testosterone under the influence of 5-alpha reductase. Thus, 5-alpha reductase inhibitors (5-ARIs) effectively reduce the serum and intraprostatic concentration of DHT, causing an involution of prostate tissue...
January 2018: Asian Journal of Urology
Chi-Cheng Chen, Chi-Ping Huang, Yi-Tung Tsai, Teng-Fu Hseih, Chih-Rong Shyr
BACKGROUND/AIM: Since androgens affect urothelial bladder cancer (UBC), we examined whether 5α-reductases (5-AR) have genomic alterations in UBC and whether 5α-reductase inhibitors (5-ARI) affect UBC. MATERIALS AND METHODS: The cBioPortal was used to analyze genomic alternations of 5-ARs in UBC cancer genomic datasets. Next, we used the Taiwan National Health Insurance Research database to conduct a population-based case-control study to investigate the effect of a 5-ARI, finasteride on UBC incidence...
December 2017: Anticancer Research
Hee Joon Bae, Omar Mian, Dhananjay Vaidya, Theodore L DeWeese, Daniel Y Song
INTRODUCTION: Prostate hypertrophy, median lobe hypertrophy, and pubic arch interference (PAI) are relative contraindications to brachytherapy because of potential morbidity and technical considerations. GnRH analogs or non-steroidal anti-androgens are currently utilized to achieve prostatic downsizing prior to brachytherapy. However, such agents have been associated with effects on body habitus, metabolism, and quality of life. In contrast, 5-alpha reductase inhibitors (5-ARI) are far less frequently associated with these morbidities...
October 10, 2017: Practical Radiation Oncology
Michael A Liss, Ian M Thompson
PURPOSE OF REVIEW: We review the concepts surrounding prostate cancer prevention strategies with 5-alpha reductase inhibitors (5-ARIs) and the controversies associated with their use. RECENT FINDINGS: Updated data have shown no increased risk of death from the diagnosis of higher risk cancer; however, 5-ARIs remain controversial and not approved for prostate cancer prevention. SUMMARY: The main theme of the review identifies the success of reducing insignificant prostate cancer and the controversy with the increased association of higher risk prostate cancer by approximately 20%...
January 2018: Current Opinion in Urology
Lucie-Marie Scailteux, Frédéric Balusson, Sébastien Vincendeau, Nathalie Rioux-Leclercq, Emmanuel Nowak
Benign prostate hypertrophy (BPH) could be associated with low urinary symptoms requiring medical treatment: 5 alpha-reductase inhibitors (5-ARI) or ɑ-blockers. Two clinical trials investigating 5-ARI use in prostate cancer (PCa) primary prevention highlighted a potential safety signal with an increased risk of high grade PCa. Later observational studies failed to show similar results but have some limits. The present paper focuses on describing the protocol of the CANARI study and its feasibility, as regards the matching process of two pseudo-anonymous databases...
August 30, 2017: Fundamental & Clinical Pharmacology
Claire Pascoe, Darren Ow, Marlon Perera, Henry H Woo, Greg Jack, Nathan Lawrentschuk
Benign prostatic hyperplasia (BPH) is a common pathology causing lower urinary tract symptoms (LUTS) and may significantly impact quality of life. While transurethral resection of the prostate (TURP) remains the gold standard treatment, there are many evolving technologies that are gaining popularity. Photoselective vaporization of the prostate (PVP) is one such therapy which has been shown to be non-inferior to TURP. We aimed to review the literature and discuss factors to optimise patient outcomes in the setting of PVP for BPH...
July 2017: Translational Andrology and Urology
Charles Dai, Vishnu Ganesan, Joseph Zabell, Yaw A Nyame, Nima Almassi, Daniel J Greene, Daniel Hettel, Chad Reichard, Samuel C Haywood, Hans Arora, Anna Zampini, Alice Crane, Jianbo Li, Ahmed Elshafei, Cristina Magi-Galluzzi, Robert J Stein, Khaled Fareed, Michael Gong, J Stephen Jones, Eric A Klein, Andrew J Stephenson
PURPOSE: We determined the effect of 5-ARIs (5α-reductase inhibitors) on disease reclassification in men with prostate cancer optimally selected for active surveillance. MATERIALS AND METHODS: In this retrospective review we identified 635 patients on active surveillance between 2002 and 2015. Patients with favorable cancer features on repeat biopsy, defined as absent Gleason upgrading, were included in the cohort. Patients were stratified by those who did or did not receive finasteride or dutasteride within 1 year of diagnosis...
August 5, 2017: Journal of Urology
Daniel Taussky, Julie Piotte, Kevin C Zorn, Marc Zanaty, Vimal Krishnan, Carole Lambert, Jean-Paul Bahary, Marie-Claude Beauchemin, Maroie Barkati, Cynthia Ménard, Guila Delouya
OBJECTIVE: To investigate the impact of 5‑alpha-reductase inhibitor (5-ARI) use on radiotherapy outcomes for localized prostate cancer. PATIENTS AND METHODS: We included 203 patients on a 5-ARI from our institutional database comprising over 2500 patients who had been treated with either external beam radiotherapy (EBRT) or brachytherapy for localized prostate cancer. Patients received a 5-ARI for urinary symptoms or active surveillance. Cancer progressions at the time of definitive treatment were analyzed according to the following criteria: (a) progression of Gleason score or increase in cancer volume on biopsy, (b) first biopsy positive for cancer after being treated for urinary symptoms with a 5-ARI, and (c) prostate-specific antigen (PSA) progression with or without a previous cancer diagnosis...
July 10, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Adam J Rensing, Adrienne Kuxhausen, Joel Vetter, Seth A Strope
INTRODUCTION: Benign prostatic hyperplasia is a prevalent chronic condition with expenditures exceeding $1 billion each year. Little is known about management of patients by primary care physicians compared to urologists. We assessed changes in management after medication initiation in these two settings. METHODS: From the Chronic Condition Warehouse 5% sample of Medicare beneficiaries linked to Medicare Part D data, we defined a cohort of men, 66 to 90 years old, with initial prescriptions for alpha-blocker, 5-alpha reductase inhibitor (5-ARI), or both...
May 2017: Urology Practice
Aditya Dutta, Sukanya Panja, Renu K Virk, Jaime Yeji Kim, Roseann Zott, Serge Cremers, David M Golombos, Deli Liu, Juan Miguel Mosquera, Elahe A Mostaghel, Christopher E Barbieri, Antonina Mitrofanova, Cory Abate-Shen
BACKGROUND: Although men on active surveillance for prostate cancer (PCa) may benefit from intervention with 5α-reductase inhibitors (5-ARIs), it has not been resolved whether 5-ARIs are effective for delaying disease progression and, if so, whether specific patients are more likely to benefit. OBJECTIVE: To identify molecular features predictive of patient response to 5-ARIs. DESIGN, SETTING, AND PARTICIPANTS: Nkx3.1 mutant mice, a model of early-stage PCa, were treated with the 5-ARI finasteride, and histopathological and molecular analyses were performed...
October 2017: European Urology
Teemu J Murtola, Anniina Virkku, Kirsi Talala, Ulf-Håkan Stenman, Kimmo Taari, Teuvo L J Tammela, Anssi Auvinen
PURPOSE: Prostate cancer screening with prostate specific antigen reduces prostate cancer mortality but leads to over diagnosis of indolent prostate cancer. The use of 5α-reductase inhibitors lowers prostate specific antigen and in theory could affect the performance of prostate specific antigen based screening. We evaluated the outcomes of prostate cancer screening in 5α-reductase inhibitors users. MATERIALS AND METHODS: The study was performed in FinRSPC (Finnish Randomized Study of Screening for Prostate Cancer)...
February 16, 2017: Journal of Urology
Olga Starobinets, John Kurhanewicz, Susan M Noworolski
The purpose of this study was to determine whether 5α-reductase inhibitors (5-ARIs) affect the discrimination between low-grade prostate cancer and benign tissues on multiparametric MRI (mpMRI). Twenty men with biopsy-proven Gleason 3 + 3 prostate cancer and 3 T mpMRI were studied. Ten patients (Tx) had been receiving 5-ARIs for at least a year at scan time. Ten untreated patients (Un) were matched to the treated cohort. For each subject two regions of interest representing cancerous and benign tissues were drawn within the peripheral zone of each prostate, MR measures evaluated, and cancer contrast versus benign (contrast = (MRTumor  - MRHealthy )/MRHealthy ) calculated...
May 2017: NMR in Biomedicine
Lauren P Wallner, Julia R DiBello, Bonnie H Li, Stephen K Van Den Eeden, Sheila Weinmann, Debra P Ritzwoller, Jill E Abell, Ralph D'Agostino, Ronald K Loo, David S Aaronson, Kathryn Richert-Boe, Ralph I Horwitz, Steven J Jacobsen
OBJECTIVE: To compare the risk of prostate cancer mortality among men treated with 5- alpha reductase inhibitors (5-ARIs) with those treated with alpha-adrenergic blockers (ABs) in community practice settings. PATIENTS AND METHODS: A retrospective matched cohort (N=174,895) and nested case-control study (N=18,311) were conducted in 4 regions of an integrated health care system. Men 50 years and older who initiated pharmaceutical treatment for benign prostatic hyperplasia between January 1, 1992, and December 31, 2007, and had at least 3 consecutive prescriptions were followed through December 31, 2010...
December 2016: Mayo Clinic Proceedings
Ankur Bansal, Aditi Arora
OBJECTIVE: To determine the efficacy of short duration use of finasteride and dutasteride prior to transurethral resection of prostate (TURP) on intraoperative blood loss and microvessel density (MVD) of prostate stroma and suburethral tissues in benign prostatic hyperplasia (BPH) Methods: This study includes 450 patients who were planned for TURP. They were prospectively randomized into three groups (150 patients each). Group 1 received placebo, group 2 received finasteride 5 mg/day and group 3 patients received dutasteride 0...
January 11, 2017: Journal of Endourology
Chris Olesovsky, Anil Kapoor
Benign prostatic hyperplasia (BPH) is an age-related phenomenon associated with prostatic enlargement and bladder outlet obstruction that can cause significant lower urinary tract symptoms (LUTS). These LUTS have a negative impact on an individual's quality of life, which is why treatment of symptomatic BPH has become a major priority. Although surgical interventions exist for treating BPH, pharmacological therapies are often preferred due to their minimal invasiveness and high degree of effectiveness. The three classes of drugs approved for treating BPH include α-blockers, 5-α-reductase inhibitors (5-ARIs) and phosphodiesterase 5 (PDE-5) inhibitors...
August 2016: Therapeutic Advances in Urology
Josephina G Kuiper, Irene D Bezemer, Maurice T Driessen, Averyan Vasylyev, Claus G Roehrborn, Fernie J A Penning-van Beest, Ron M C Herings
BACKGROUND: Previous studies have suggested a greater benefit for various outcomes in men diagnosed with benign prostatic hyperplasia (BPH) who are treated with dutasteride than for men treated with finasteride. This study investigates whether the rates of BPH-related prostate surgery and acute urinary retention (AUR) differ between dutasteride and finasteride users in the Netherlands. METHODS: From the PHARMO Database Network, men aged ≥50 years with a dispensing of dutasteride or finasteride with or without concomitant alpha-blocker treatment between March 1, 2003 and December 31, 2011 were selected...
August 31, 2016: BMC Urology
Vincenzo Favilla, Giorgio Ivan Russo, Salvatore Privitera, Tommaso Castelli, Raimondo Giardina, Aldo E Calogero, Rosita A Condorelli, Sandro La Vignera, Sebastiano Cimino, Giuseppe Morgia
Lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO) represent one of the most common clinical complaints in adult men. Several drugs used for LUTS/BPO may strongly affect sexual function and bother. The aim of this systematic review and meta-analysis was to evaluate the impact of combination therapy with alpha-blockers (AB), 5-alpha reductase inhibitors (5-ARI) on the risk of erectile dysfunction(ED) and libido alterations (LA) from randomized clinical trial (RCT). Based on the inclusion and exclusion criteria, five RCTs involving 6131 patients were included in the analysis...
September 2016: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
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