Inhibitors of 5α reductase suppress the conversion of testosterone to the more active form – dihydrotestosterone, resulting in the reduction of proliferation of both benign and malignant prostate tissue; can thus slow the progression of the disease during active surveillance for patients with prostate cancer.
Objective aim. Improve the efficiency of the treatment of prostate cancer at low risk that is under active surveillance by using 5α reductase inhibitors.
Materials and methods. Results of treatment of 96 patients with prostate cancer at low risk, combined with benign prostatic hyperpla sia that were under active surveillance from 2008 to 2015 to reduce the risk of disease progression and reduce symptoms of lower urinary tract in all patients prescribed finasteride (Proscar, Prostan) at a dose of 5 mg a day. We determined the time to prostate specific antigen (PSA) and histological progression analysis the number of patients who underwent radical treatment, and the impact of treatment on prostate size and the quality of life of patients.
Results. The period of observation of patients ranged from 12 to 86 months (46,2 ± 33,6). Despite no evidence of disease progression, refused to conduct further active observation during the first two years, 11 (11.5%) patients. Average time to disease progression by PSA level was 32.2 months. According to histological study, progression was diagnosed in 16 (16.7%) with an average attack time to progres sion – 38.4 months. 62 (64.6%) patients continue to be under the active supervision of the average duration – 46.2 months. In 26 (27.1) patients who went out from under active surveillance by choice or due to disease progression, subsequently conducted a radical treatment (radical prostatectomy or radiation therapy). The use of inhibitors of 5α reductase led to a reduction in the size of the prostate by 23%, improving urination and, consequently, the quality of life of patients.
Conclusion. The use of inhibitors of 5α reductase during active sur veillance for patients with prostate cancer at low risk prostate volume reduced by 23%, improve the sensitivity of PSA, prostate biopsy and digital rectal examination. Patients with prostate cancer who use inhibitors of 5α reductase have a lower rate of progression (16.7%) and less likely to abandon active surveillance (11.5%).
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