Major Role for 5-Alpha Reductase Inhibitors in the Aging Male

    Neil Fleshner
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    TLDR 5-alpha reductase inhibitors help treat prostate issues in aging men, but their role in cancer prevention is debated.
    The document discussed the role of 5-alpha reductase inhibitors (5ARIs) in treating benign prostatic hyperplasia (BPH) and their potential in prostate cancer prevention. The Canadian consensus meeting highlighted the significant benefits of 5ARIs in reducing long-term complications and lower urinary tract symptoms associated with BPH. However, the impact of 5ARIs on prostate cancer prevention was controversial, with some limitations noted in the recommendations. The document suggested that both finasteride and dutasteride were effective, with theoretical advantages for dutasteride in cancer prevention. Clinicians were advised to consider 5ARIs for men with large-volume BPH and LUTS, and for primary prevention in ultra-high risk men, with finasteride being supported by the best evidence in such cases.
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