ATLANTA—A significant proportion of men take 5-alpha reductase inhibitors (5-ARIs) and alpha blockers following radical prostatectomy (RP) even though these medications have no proven role post-RP, according to study findings presented at the American Urological Association 2012 annual meeting.
Sandip Prasad, MD, a urologic oncology fellow at the University of Chicago, and collaborators performed a population-based observational cohort study using Surveillance, Epidemiology and End Results (SEER)-Medicare linked data to study 9,186 men diagnosed and treated for prostate cancer (PCa). Among newly diagnosed men, 47% received radiation therapy, 25% had RP, 17% underwent active surveillance, and 11% had androgen deprivation therapy. Use of preoperative 5-ARIs was lowest in men undergoing RP (2.0%) and highest in the active surveillance group (4.3%). Baseline use of alpha blockers was greatest in patients treated with radiotherapy (15.2%) and lowest in those managed with active surveillance (9.2%).
Following PCa treatment, the use of overactive bladder medication increased sixfold in the RP group and doubled in the radiation therapy group. Use of 5-ARIs decreased after treatment in all groups example those managed with active surveillance. Alpha blocker use decrease after treatment in all groups except those who underwent radiation therapy, where an additional 12.7% of patients began to use these medications after treatment, Following RP, 3.7% of patients continued to use alpha blockers.