Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0282612 (PIN)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over the past 15 years, the number of US males diagnosed with prostate cancer has increased 350% because of the aging of the population and improved detection with the prostate specific antigen (PSA) blood test. A new strategy to case management is chemoprevention, or early intervention with a well-tolerated drug. It is believed that prostate cancer is initiated when a cell undergoes genetic changes with malignant potential. Next, the cancer grows, or is promoted, until it is prominent, detectable, and has acquired a propensity to spread. Primary chemoprevention intervenes in the initiation and promotion process. Secondary chemoprevention involves early detection, treatment, and cure. Chemoprevention research, therefore, is focusing on identification of active agents that will be well tolerated in the general population, such as micronutrients as vitamins and minerals. For example, research indicates that intake of lycopene or other components in tomatoes may reduce prostate cancer risk. Other researchers are testing a drug to block the activity of the enzyme 5-alpha reductase, because men deficient in this enzyme fail to develop prostate cancer. Other agents under investigation are selenium, vitamin E, nonsteroidal anti-inflammatory drugs, retinoids, and a compound known as DFMO, which stabilizes cellular DNA. Efforts are also being made to reverse cases of prostatic intraepithelial neoplasia, which is thought to be a precursor of cancer. Eventually, predictions of degree of risk will be used to include men in chemoprevention trials.
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PMID:Chemoprevention and prostate cancer. 1232 68

Prostate cancer remains a significant public health problem. The current approach with prostate-specific antigen (PSA)-based screening has questionable effects on prostate cancer-specific mortality but is clearly associated with overdiagnosis of prostate cancer, especially relatively low-risk and low-volume tumors. Methods to decrease overdiagnosis include alterations in screening practices and, potentially, the use of 5-alpha reductase inhibitors. This article reviews the major trials that have evaluated 5-alpha reductase inhibitors in this setting: the Prostate Cancer Prevention Trial (PCPT) and the Reduction by Dutasteride Prostate Cancer Events Trial (REDUCE). Although these trials enrolled different patient populations, their findings are complementary and suggest a potential role for these agents in prostate cancer risk reduction. Use of 5-alpha reductase inhibitors results in an approximate 25% reduction in the detection of prostate cancer, reduces diagnosis of high-grade prostatic intraepithelial neoplasia (PIN), and improves benign prostatic hyperplasia (BPH)-related outcomes and the performance of PSA as a diagnostic test for aggressive prostate cancer. Side effects occur in a small percentage of men and consist of decreased sexual function and libido as well as gynecomastia. The risk of high-grade tumor development while receiving these agents is uncertain.
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PMID:The case for prostate cancer risk reduction by 5-alpha reductase inhibitors. 2445 15