Prevention strategies in prostate cancer

Prostate cancer (PCa) prevention has been an exciting and controversial topic since the results of the Prostate Cancer Prevention Trial (PCPT) were published. With the recently published results of the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) trial, interest in this topic is at a peak. Primary PCa prevention will be unlikely to affect mortality significantly, but the reduction in overtreatment and the effect on quality of life from the avoidance of a cancer diagnosis are important factors to consider. This review provides a comparative update on the REDUCE and PCPT trials and some clinical recommendations. Other potential primary preventive strategies with statins, selective estrogen response modulators, and nutraceutical compounds including current evidence for these agents and their roles in clinical practice are discussed. Many substances that have been examined in the primary prevention of PCa and for which clinical data are either negative or particularly weak are not covered. The future of PCa prevention continues to expand, with several ongoing clinical trials and much interest in tertiary prostate cancer prevention.