Editorial Comment

Abstract

The use of 5-ARIs in men undergoing active surveillance for low-risk PCa has been controversial. This study adds data that 5-ARI therapy could be beneficial. The results are consistent with those from the REDEEM trial in that a significant majority (75%) of men receiving 5-ARI had no evidence of pathologic cancer progression at the restaging biopsy after a median follow-up of 35 months. Active Surveillance of Very-low-risk Prostate Cancer in the Setting of Active Treatment of Benign Prostatic Hyperplasia With 5α-reductase InhibitorsUrologyVol. 81Issue 5PreviewTo review the efficacy of treating benign prostatic hyperplasia and very-low-risk prostate cancer (PCa) in patients receiving active surveillance and 5α-reductase inhibitor (5-ARI; finasteride or dutasteride) treatment. Full-Text PDF ReplyUrologyVol. 81Issue 5PreviewConsistent with the findings from the REDEEM trial, our outcomes suggest that 5-ARIs do not increase the risk of intermediate- or high-risk PCa (Gleason score 7-10) in men receiving active surveillance. Our study demonstrates only a small risk of progression to Gleason score 7 cancer on repeat biopsy. We believe this can be attributed to detection bias, as the gland volume reduction from 5-ARI therapy—along with the simple increase in total cumulative number of biopsy cores taken over time—enhances the clinician's ability to find higher grade PCa. Full-Text PDF