Take-Home Points
Where does that leave us? There are a couple of points to take away here. First, when the Prostate Cancer Prevention Trial investigators presented the initial results, many people were enthusiastically endorsing the use of finasteride to prevent prostate cancer. But this study shows that without having the mortality data, it would have been premature to make that recommendation. Now we find that although you might be less likely to be diagnosed with prostate cancer [after taking finasteride], it doesn't matter in terms of overall survival. Those men who did not receive finasteride lived just as long as those men who did.
The bottom line here is that with the more mature data, it is difficult to make a strong recommendation for the use of finasteride to prevent prostate cancer. Whether or not finasteride has some impact on the survival of men who have been diagnosed with prostate cancer will depend on findings from a different study.
I do believe that this is a very important finding, because it says that even though you are less likely to be diagnosed with prostate cancer [when you take finasteride], it does not change your survival -- so what's the point of going on that therapy? This is important to convey to your patients. Any man who has been taking finasteride in the hope of preventing prostate cancer should be informed that it does not seem to make a difference in terms of how long they live.
I look forward to your comments. Thank you.