Tuesday, June 15, 2010

Prostate cancer drug risks heart failure and sexual dysfunction

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14 June 2010

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  • Prostate cancer drug risks heart failure and sexual dysfunction

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Prostate Cancer Drug Risks Heart Failure and Sexual Dysfunction

Dear Reader,

Men, if your doctor recommends a drug called Avodart (dutasteride) to help lower your risk of prostate cancer, he's going to offer some evidence that might seem convincing.

What's the rush

Avodart is designed to treat enlarged prostate (also known as BPH, or benign prostatic hyperplasia). In a recent New England Journal of Medicine (NEJM) study, about 3,300 men at high risk of prostate cancer took Avodart for four years. About 3,420 men — also at high risk — took a placebo.

Compared to placebo, the relative risk of any level of prostate cancer was reduced by nearly 23 per cent in the Avodart group.

So based purely on that number, your doctor might encourage you to take Avodart if you're at high risk of prostate cancer. And keep in mind that every man between the ages of 50 and 75 is considered high risk.

But let's look a little deeper before you fill that prescription...

* In years one through four, nearly all subjects underwent a needle biopsy

* Among 3,299 men in the Avodart group, 220 tumours were detected with moderate to high Gleason scores (the system that rates the aggressiveness of tumours).

* Among 3,407 men in the placebo group, 233 tumours were detected with moderate to high Gleason scores.

* During years three and four, 12 tumours with high Gleason scores were discovered in the Avodart group, but only one in the placebo group.

So when it comes to aggressive tumours, Avodart doesn't appear to reduce risk at all.

And then there were the side effects: Sexual dysfunction was significantly higher in the Avodart group, and — even more important to know — subjects in that group were nearly twice as likely to experience heart failure compared to placebo.

The doctor will see you now...

At this point, any man who's still on the fence about using this expensive drug to prevent prostate cancer should consider a second opinion from an experienced urologist. Someone like Dr. Patrick Walsh.

Dr. Walsh is currently a Distinguished Service Professor of Urology at Baltimore's Johns Hopkins School of Medicine, in the US, where he served as Urologist-in-Chief for 30 years. In other words, when it comes to man-plumbing, Dr. Walsh knows his stuff.

An editorial by Dr. Walsh appears in the same NEJM issue as the Avodart study. And to get the full gist, you'll need to know that "dutasteride" is the generic name for Avodart, and "finasteride" is the generic name for Proscar, another popular BPH drug.

Shrinking violet

Dr. Walsh: "Dutasteride and finasteride do not prevent prostate cancer but merely temporarily shrink tumours that have a low potential for being lethal, and they do not reduce the risk of a positive biopsy in patients who have an elevated PSA level."

And just last year, in the journal Prostate Cancer Discovery, Dr. Walsh had this to say about finasteride: "Men will believe that it prevents cancer, will be pleased that their PSA levels fall, and will not understand the potential danger they're in — of undiagnosed high-grade disease."

In a recent interview with, Dr. Walsh said his 2009 comments about finasteride also apply to dutasteride.

Speaking specifically about the Avodart study, he said the results showed, "there was a 23 per cent reduction in low- grade tumours that the patients would never have known they had. Does this sound like an indication to take a pill with sexual side effects that costs $4 a day?"

If Dr. Walsh is unimpressed with the Avodart study results, there's no reason you or your doctor should be impressed.

Continues below...

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...and another thing

I wonder if Christie Aschwanden's e-mail inbox suddenly filled up a few days ago.

You may recall Christie's name from a previous e-Alert. I took her to task for writing an article that brimmed with ridiculous arguments against dietary supplement use, and multivitamin use in particular.

She compared belief in the value of multivitamins to belief in the tooth fairy.

Well...then leave a fiver under my pillow because the tooth fairy is in business.

A new study, presented at the annual meeting of the American Association for Cancer Research, shows that multivitamin use may cut breast cancer risk by more than 30 per cent.

Other results of the study:

* Use of calcium supplements was linked to a 40 per cent reduced risk in breast cancer

* Use of vitamin A, C, and E supplements were linked to slightly lower breast cancer risk

* Researchers say their results suggest that vitamin supplements are more effective at supporting cancer prevention when taken together rather than individually

You've got to wonder how many people saw that study and forwarded it to Christie. I hope it was a LOT!

More importantly, we can only hope that ALL her readers saw these results too!

To Your Good Health,

Jenny Thompson
HSI Director


P.S. This month's Health Sciences Institute (HSI) newsletter will tell you about the all-natural formula set to succeed against infections where antibiotics have failed. You'll also discover how to give yourself a 74 per cent chance of survival from sudden cardiac arrest. Plus we'll give you full details on how a substance found in broccoli could revolutionise the way we tackle cancer.

All new members who sign up to the Health Sciences Institute will receive the latest issue of HSI along with a FREE encyclopaedia, HSI's 100 Greatest Underground Cures... Soon you'll discover why our premium members believe HSI is the ultimate resource for anyone seeking a better, newer solution to their health problems.

Click here for full details.
Sources:

"Effect of Dutasteride on the Risk of Prostate Cancer" New England Journal of Medicine, Vol. 362, No. 13, 4/1/10, content.nejm.org

"Dutasteride Results Reignite Debate about Prevention of Prostate Cancer" Zosia Chustecka, Medscape, 3/31/10, medscape.com

"Finasteride: Are the Risks Worth it?" Prostate Cancer Discovery, Vol. 5, Winter 2009, urology.jhu.edu

"Multivitamins May Cut Breast Cancer Risk" Charlene Laino, WebMD Health News, 4/19/10, webmd.com

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