BERKELEY, CA (UroToday.com) - Analysis of patients on finasteride vs. placebo in the Prostate Cancer Prevention Trial (PCPT) suggests that the sexual dysfunction of men on finasteride is slight and limited in duration. The report of Carol Moinpour and colleagues appears in the Journal of the National Cancer Institute.

The PCPT was a 7 year blinded and randomized trial of finasteride 5mg per day vs. placebo to evaluate the efficacy of preventing prostate cancer (CaP). A 24.8% reduction in the prevalence of CaP among men taking finasteride was reported. In these studies participants completed questionnaires (the Sexual Problems Scale and the Sexual Activity Scale) and sexual toxicity ratings were complied by the research team. The participant reported measures were recorded at time of study enrollment, at randomization, at 6 months, and annually for 7 years. In addition, a Participant Lifestyles survey assessed the health behaviors of smoking status, physical activity, diet, and alcohol use.

Demographic and clinical variables were similar among the two treatment arms. A statistically significant increase in sexual dysfunction was found on the Sexual Activity Scale score with finasteride participants on average 3.21 points higher than those taking placebo at first assessment. This decreased to 2.11 points at the end of study. Following adjustment for covariates mean sexual dysfunction increased in both the finasteride and placebo arms at 6 months from baseline by 1.26 points per year. The cumulative increase was 8.2 points over the entire study period.

Overall, the effect of finasteride on sexual function was statistically significant but clinically minimal and it decreased with time. The authors conclude that patients should not hesitate to take finasteride for prostate cancer chemoprevention due to concerns over sexual dysfunction.

Moinpour CM, Darke AK, Donaldson GW, Thompson IM, Langley C, Ankerst DP, Patrick DL, Ware JE, Ganz PA, Shumaker SA, Lippman SM, Coltman CA

J Natl Cancer Inst. 99(13):1025-35, July 2007
doi:10.1093/jnci/djm023

UroToday.com Prostate Cancer Section

Written by Christopher P. Evans, MD, a Contributing Editor with UroToday.

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