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5-Alpha Reductase Inhibitors in Prostate Cancer

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Drug Management of Prostate Cancer

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Abstract

Androgenic effects in prostate cancer cells depend on the synthesis and metabolism of hormones and the presence of androgen receptor. 5-alpha reductase isoenzymes I and II differ in chromosomal localization, pH optimum, enzyme kinetics, and expression in benign and malignant prostate tissue. In prostate cancer tissues, there is an increased expression of the isoenzyme type I. The possibilities for pharmacological intervention include drug(s) that inhibit both isoforms such as dutasteride or extract from Serenoa repens or type II inhibitors such as finasteride. 5-alpha reductase inhibitors are used in benign prostate hyperplasia therapy, and it has been postulated that they may also be beneficial in preventive strategies for prostate cancer. Due to its dual effect on 5-alpha reductase inhibition, dutasteride may be preferred over finasteride for prostate cancer prevention. Data from large clinical studies have indicated that these inhibitors reduce the risk of prostate cancer; however, there are concerns that should be discussed. Importantly, there may be an increased number of high-grade Gleason tumors in patients treated with finasteride.

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Author information

Authors and Affiliations

  1. Department of Urology, Innsbruck Medical University, Innsbruck, Austria

    Zoran Culig

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  1. Zoran Culig
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Correspondence to Zoran Culig .

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Editors and Affiliations

  1. Medical Oncology Branch, NIH National Cancer Institute, Rockville Pike 9000, Bethesda, 20892, Maryland, USA

    William D. Figg

  2. Medical Oncology Branch, NIH National Cancer Institute, Rockville Pike 9000, Bethesda, 20892, Maryland, USA

    Cindy H. Chau

  3. School of Medicine, Dept. Urology, University of California, San Francisco, Divisadero Street 1600, San Francisco, 94115, California, USA

    Eric J. Small

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Culig, Z. (2010). 5-Alpha Reductase Inhibitors in Prostate Cancer. In: Figg, W., Chau, C., Small, E. (eds) Drug Management of Prostate Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-60327-829-4_7

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  • DOI: https://doi.org/10.1007/978-1-60327-829-4_7

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  • Online ISBN: 978-1-60327-829-4

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