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I think the former study was far too small and complex to draw any conclusions, but was introduced to a new term for proxy measurement of tumour activity - the Ki-67 index Hmmm..... I wonder how accurate that measurement is and how good the studies are behind it??
But any study involving dutasteride/finasteride must eventually revert to the enormous argument that broke out when the PCAT (Prostate Cancer Prevention Trial) was stopped. It was my opinion then, and still is, that Dr Gleason's view was right. Dutasteride/finasteride alters the cellular structure of the prostate gland and the Gleason scoring system cannot be used. That means that the cells identified as more aggressive during the trial AND the ones identified as less aggressive might be equally incorrect.
This seems to be borne out by the conclusion quoted:
With follow-up of 18 years, finasteride administration for 7-years does not appear to affect mortality but significantly reduces the risk of a … diagnosis [of prostate cancer].
The risk of diagnosis being reduced may well have been because the cells from a biopsy did not meet the criteria of the Gleason system because of their structural change and therefore no 'cancer' label was attached.
Just my (skewed no doubt) view of the world. Hope nobody is misled by my expressing it!!
