Painkillers May Prevent Prostate Problems

By: Sylvia Booth Hubbard

Over-the-counter painkillers like Advil and aspirin may help men stave off prostate problems, according to two new studies. However, medical experts are quick to warn men not to self-medicate, and especially not to take more than recommended dosages.

The preventive painkillers fall into the general class of drugs called “non-steroidal anti-inflammatory drugs” or NSAIDs. Ibuprofen is one, and well-known brands include Advil, Motrin, and Nuprin. Other members of the NSAIDs class are naproxen (brand name “Aleve”) and aspirin.

“Our data suggest if men are taking these [medications] for another problem, it might prevent urological problems as well,” Mayo Clinic epidemiologist Jennifer St. Sauver told HealthDay News. St. Sauver’s study showed that men who took NSAIDs on a daily basis reduced the enlargement of their prostate glands by about 50 percent. Such enlargement, called “benign prostatic hyperplasia” or BPH, is common in men over forty, affecting about 50 percent of men by age 50, and about 75 percent by age 80.

The other study was led by Dr. Eric A. Singer, who is chief resident in urology at the University of Rochester Medical Center in New York. Singer’s team found that NSAIDs lowered PSA (prostate specific antigen) levels by about 10 percent. PSA, which is produced by the cells of the prostate gland and is normally present in small amounts, is frequently elevated by disorders of the prostate, including prostate cancer. Some of the men in Singer’s study took acetaminophen (brand name “Tylenol”), which also apparently reduced PSA levels. However, not enough men in the study took it to be statistically significant.

Both St. Sauver and Singer speculated that NSAID’s anti-inflammatory action was the probable role-player in helping prevent prostate problems. Both researchers also caution men that NSAIDs can trigger kidney ailments, liver toxicity, and other health problems. “We are certainly not telling men to take NSAIDs to reduce PSA or cancer risk,” Singer said. “Talk to your health-care provider about prostate health and prostate cancer screening, and make sure your doctor knows what medications you are taking.”
According to the American Cancer Society, close to 200,000 men in the U.S. are diagnosed with prostate cancer every year, and one in six men develop it at some point in their life.

Prognostic significance of 5-year PSA value for predicting prostate cancer recurrence

PURPOSE: To analyze the prognosis and outcomes of patients who remain free of biochemical failure during the first 5 years after treatment.

METHODS AND MATERIALS: Between 1991 and 2002, 742 patients with prostate cancer were treated with brachytherapy alone (n = 306), brachytherapy and hormonal therapy (n = 212), or combined implantation and external beam radiotherapy (with or without hormonal therapy; n = 224). These patients were free of biochemical failure (American Society for Therapeutic Radiology and Oncology [ASTRO] definition) during the first 5 post-treatment years and had a documented 5-year prostate-specific antigen (PSA) value. The median follow-up was 6.93 years.

RESULTS: The actuarial 10-year freedom from PSA failure rate was 97% using the ASTRO definition and 95% using the Phoenix definition. The median 5-year PSA level was 0.03 ng/mL (range, 0-3.6). The 5-year PSA value was 0.01-0.10 in 31.1%, >0.10-0.2 in 10.2%, >0.2-0.5 in 7.82%, and >0.5 in 3.10%. The 5-year PSA value had prognostic significance, with a PSA value of or=0.2 ng/mL (n = 81; p < .0001). The treatment regimen had no effect on biochemical failure. None of the 742 patients in this study developed metastatic disease or died of prostate cancer.

CONCLUSION: The results of this study have shown that the prognosis for patients treated with brachytherapy and who remain biochemically free of disease for >or=5 years is excellent and none developed metastatic disease during the first 10 years after treatment. The 5-year PSA value is prognostic, and patients with a PSA value <0.2 ng/mL are unlikely to develop subsequent biochemical relapse

Stock RG, Klein TJ, Cesaretti JA, Stone NN.
Department of Radiation Oncology, Mount Sinai Hospital, New York, NY 10029, USA