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5-Alpha-Reductase Inhibition as a Secondary Preventive Strategy

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Imaging and Focal Therapy of Early Prostate Cancer

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

5-Alpha-reductase inhibitors (5-ARIs) block the conversion of testosterone to dihydrotestosterone, thereby reducing prostate volume and prostate-specific antigen (PSA). There is evidence that its use may also deter prostate cancer tumor growth. In large multinational randomized controlled trials (RCTs), 5-ARIs have been demonstrated to reduce prostate diagnosis by 25 %. There is observational data suggesting that for men with low-risk, localized prostate cancer on active surveillance, 5-ARI use prevents disease progression and clinical interventions. In a North American RCT, the ability of dutasteride to prevent prostate cancer progression was tested against placebo (composite measure of clinical and pathological progression), and 10 % fewer patients in the treatment group had a progression event. Specialty organizations are mixed in their endorsement of 5-ARIs for secondary prevention of prostate cancer for men on active surveillance. Ongoing studies are exploring the visible tumor change on multiparametric magnetic resonance imaging (mpMRI) for men using dutasteride versus placebo on active surveillance.

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Author information

Authors and Affiliations

  1. Department of Urologic Oncology, University of Toronto, Toronto, ON, Canada

    Nathan Perlis

  2. Division of Urology, Department of Surgical Oncology, University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Nathan Perlis

  3. Division of Urology/Uro-Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Antonio Finelli

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  1. Nathan Perlis
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  2. Antonio Finelli
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Correspondence to Antonio Finelli .

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Editors and Affiliations

  1. Department of Surgery, Duke Cancer Institute, Durham, North Carolina, USA

    Thomas J. Polascik

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Perlis, N., Finelli, A. (2017). 5-Alpha-Reductase Inhibition as a Secondary Preventive Strategy. In: Polascik, T. (eds) Imaging and Focal Therapy of Early Prostate Cancer. Current Clinical Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-49911-6_30

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  • DOI: https://doi.org/10.1007/978-3-319-49911-6_30

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49910-9

  • Online ISBN: 978-3-319-49911-6

  • eBook Packages: MedicineMedicine (R0)

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