Risk Reduction

Results of a trial published Jan. 24 in the New England Journal of Medicine indicate that the hormone-blocking drug finasteride can be safely used to reduce risk of prostate cancer. Previous results from the large trial, called the Prostate Cancer Prevention Trial, showed that the drug reduced risk of developing prostate cancer overall but that it increased risk of developing high-grade prostate cancers. But after following the men enrolled in the trial for a median 18.4 years, researchers have concluded that the drug does not increase risk of death from prostate cancer. Finasteride is already approved by the U.S. Food and Drug Administration to treat hair loss and enlarged prostate. The researchers say that taking finasteride may prevent men from developing prostate cancer and then receiving treatments that reduce quality of life. “Finasteride is safe, inexpensive and effective as a preventive strategy for prostate cancer,” said study co-author Ian Thompson Jr., in a press release. “Doctors should share these results with men who get regular prostate-specific antigen tests that screen for the presence of prostate cancer.”

Financial Toxicity Update

A study published Jan. 21 in Cancer explores financial toxicity among cancer patients. Using results from the National Health Interview Survey, a survey of U.S. households, the researchers found that people who have received a cancer diagnosis are more likely to experience financial hardship than those without any history of cancer. The researchers asked about material hardship, such as trouble paying medical bills, but also psychological hardship related to worrying about medical bills, and behavioral hardship, defined as forgoing health care due to cost concerns. Younger survivors ages 18 to 49 reported elevated rates of hardship in all three areas. The researchers also found that among those with private insurance, having a high-deductible plan without a health savings account was associated with increased risk of hardship.

Direct-to-Consumer Testing Expands

In March 2018, the direct-to-consumer genetic testing company 23andMe gained authorization from the U.S. Food and Drug Administration to tell people whether they have any of three cancer risk-related mutations ​in their BRCA genes. On Jan. 22, 23andMe announced that it has also been cleared to tell people whether they have genetic variants that cause a condition called MUTYH-associated polyposis. The condition is associated with increased colorectal cancer risk. However, just 5 percent all colorectal cancers are caused by inherited mutations, and 0.7 percent of colorectal cancer cases are related to MUTYH-associated polyposis. The test does not give results on other hereditary colorectal cancer-related conditions, such as Lynch syndrome. And 23andMe points out that the test does not detect all possible variants linked to MUTYH-associated polyposis.​