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Last week the US Food and Drug Administration (FDA) released a warning about the increased risk of developing an aggressive form of prostate cancer while taking 5-alpha reductase inhibitors (5-ARI), such as dutasteride and finasteride. These drugs are frequently used in the treatment of benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate gland that affects nearly half of men over the age of 55. If the prostate becomes too enlarged due to BPH, it can put substantial pressure on the urethra, leading to various urologic issues including difficulty urinating.
Studies have shown that 5-ARI drugs, commonly known as Avodart, Proscar, and Propecia, have a somewhat paradoxical effect on prostate cancer. While they seem to reduce the overall rate of the disease, at the same time they may increase the risk of aggressive, high-grade cancer among those men who do get diagnosed. These findings raise the question of whether 5-ARI drugs are truly suitable for prostate cancer prevention as was previously thought.
It is important to keep in mind that these drugs are not the only effective treatments for BPH. There are, in fact, safe and minimally invasive surgical treatments available as well, such as GreenLight Laser PVP (Photo Vaporization of the Prostate) and TURP (Transurethral Resection of the Prostate).
GreenLight Laser PVP is a safe and effective outpatient procedure performed by urologists. The procedure involves inserting a thin cystoscope into the urethra to reach the prostate gland. The aspect of the gland surrounding the urethra is heated to the point where the overgrown prostate tissue becomes vaporized, thereby allowing urine to flow more freely from the bladder to outside the body. This procedure takes approximately 60 minutes, and patients are sent home that same day.
TURP (Transurethral Resection of the Prostate) is performed by visualizing the prostate through the urethra and removing overgrown prostate tissue by sharp dissection or electrocautery. TURP has been extremely well-studied in the medical literature, and is considered a common, safe and efficacious way to treat BPH.
With the information now being presented about 5-ARI drugs, men may want to reevaluate their course of treatment. So speak to your urologist and, as always, make sure to know all of your options before you reach a final decision.