Wilford Hall plays part in cancer study
by 2nd Lt. Michael Chillstrom
59th Medical Wing Public Affairs
7/2/2003 - LACKLAND AIR FORCE BASE, Texas (AFPN) -- Wilford Hall Medical Center researchers were involved in the recent study on the drug finasteride’s ability to prevent prostate cancer.
Wilford Hall was the largest study site, providing roughly 10 percent of the participant population, for the seven-year, nationwide study named the Prostate Cancer Prevention Trial, officials here said.
The trial, to be published in the July 17 edition of “The New England Journal of Medicine,” found a 25 percent reduction in prostate cancer occurrences for healthy males taking finasteride. Although the findings are far short of being a cure-all answer, physicians laud the trial’s discovery, according to officials.
“There are very few cancers that are potentially preventable by taking a medication,” said Lt. Col. (Dr.) Duane Cespedes, urology chairman and Wilford Hall’s principal investigator for the trial. “For an important cancer like prostate cancer, where 230,000 men a year are afflicted and 30,000 die, to have a pill that can reduce it by 25 percent is a major breakthrough. This is a great start.”
Of the study’s 18,882 men age 55 or older, 1,444 came from Wilford Hall. Half of them were given finasteride daily for seven years, while the other half took a placebo.
While finasteride reduced prostate cancer cases by 25 percent, some experts have publicly questioned if the side effects are worth the potential benefits.
As with most medications, there are tradeoffs involved, said Cespedes. Sexual side effects were slightly more prevalent in finasteride users than placebo participants, but urination problems associated with an enlarged prostate actually improved. All patients are in an age group susceptible to developing these problems, which may explain why the side effects occurred in the first place, he said.
A more important concern is that while the drug appears to reduce cancer cases, the trial showed a slight increase in “aggressive” tumors. Whether they are truly more aggressive is unclear as some cancers look more aggressive under a microscope, but actually act like “normal” prostate cancer, Cespedes said.
Finasteride’s “hormone effect” may be the reason for a tumor’s aggressive appearance, but at this point, no one will know until more studies are completed, he said.
Preventing prostate cancer, the second deadliest cancer among men, may become the next application for finasteride, a drug normally prescribed for enlarged prostates and, in smaller doses, for treating baldness, according to officials.
The best candidates for the drug are those in groups with higher rates of prostate cancer: black men and men with a family history of prostate cancer. Officials encourage middle-aged men to talk with their primary care physicians or urologists to determine whether finasteride is appropriate.
“Military patients are some of the best patients in the world,” said Cespedes. “They’re very responsible and very good at following doctors’ orders. A seven-year study is extremely hard on patients, but most of them stayed the course.”
With the closing of the study, many of the subjects are volunteering for a new trial called SELECT, according to officials. This is a 12-year international study that will examine using selenium and vitamin E to prevent prostate cancer.
Wilford Hall officials said they are in the top 20 of more than 300 sites chosen for the study. (Courtesy of Air Education and Training Command News Service) |
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