The story of finasteride, a drug for prostate problems, demonstrates the difficulty of judging when a proven medical treatment is worthwhile.
All men over 50 have an enlarged prostate gland and in 35 per cent it will become severe enough to cause symptoms such as difficulty in urinating and bladder infections. Some have to undergo surgery to remove the gland and the operation is now the second most common in the age group.
The drug finasteride can shrink the gland and ease the symptoms, but its long-term effect was unknown. A study conducted in 95 centres in the United States and Canada published in the New England Journal of Medicine shows that among 3,000 men treated with finasteride over four years the number needing surgery to deal with their problems was halved.
On the face of it a dramatic effect. But in an editorial, Dr John Wasson, of the Dartmouth Medical School in Hanover, New Hampshire, says: "Treatment with finasteride ... may be unwarranted for most men with this disorder." The reason is that although there was a halving of those needing surgery, the reduction in risk was small.Reuse content