In this review article, we summarize the current evidence regarding prostate cancer prevention. At this time, level I evidence provides consideration of 5-alpha reductase inhibitors in select men to prevent low risk prostate cancer. Other medications lack strong data for prevention of prostate cancer.
Additionally, natural substances, such as vitamins or other nutrients, do not have enough evidence for prostate cancer prevention and in some cases may contribute to prostate cancer risk.
Ongoing developments include dietary intervention with the Men’s Eating and Living (MEAL) Study and immunotherapy with the prostate cancer vaccine, PSA-TRICOM (PROSTVAC). MEAL is a phase III trial of men with localized prostate cancer on active surveillance with a vegetable based dietary intervention, which completed accrual in September 2015.3 Follow-up is ongoing and results are expected in 2018. PROSTVAC is a poxvirus-based vaccine containing PSA and three T-cell co-stimulatory molecules currently being studied in a randomized, double-blind, phase II trial of 90 men with localized prostate cancer on active surveillance (ClinicalTrials.gov NCT02326805). We look forward to these and other exciting developments for prostate cancer prevention.
Written By:
Zachary Hamilton, J Kellogg Parsons
Reference:
Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003; 349: 215–24.
Andriole G, Bostwick D, Brawley O, Gomella L, Marberger M, Montorsi F et al. Effect of dutasteride on the risk of prostate cancer. N Engl J Med 2010; 362: 1192–1202.
Parsons JK, Pierce JP, Mohler J, et al. A randomized trial of diet in men with early stage prostate cancer on active surveillance: rationale and design of the Men's Eating and Living (MEAL) Study. Contemp Clin Trials 2014; 38(2): 198-203.