Painkillers May Be Good for the Prostate

SATURDAY June 20, 2009 -- Taking over-the-counter painkillers such as aspirin and ibuprofen might help men avoid prostate problems.

But even so, medical experts are quick to caution men not to self-dose or to take more than the recommended amounts of these medications, because harmful side effects can result.

"Our data suggest if men are taking these [medications] for another problem, it might prevent urological problems as well," said Jennifer St. Sauver, an epidemiologist at the Mayo Clinic in Minnesota who led a study that found that men who took nonsteroidal anti-inflammatory drugs (NSAIDs) daily had a reduction of about 50 percent in enlargement of the prostate gland. The condition, called benign prostatic hyperplasia, affects many men after age 40.

The gland, about the size of a walnut, is below the bladder and surrounds the urine-carrying canal or urethra. The gland often enlarges in older men, making urination difficult.

But men in St. Sauver's study who took painkillers daily had more than a third fewer moderate to severe urinary problems than men who did not take daily painkillers.

Lower levels of prostate specific antigen (PSA) also seem to be a benefit experienced by men who take NSAIDs regularly. PSA is a biomarker in the bloodstream that is used to assess the risk of getting prostate cancer.

Dr. Eric A. Singer, chief resident in urology at the University of Rochester Medical Center in New York, led a team of researchers who found that regular use of NSAIDs yielded PSA levels 10 percent lower than in men who didn't use them. St. Sauver's study found lower PSA levels among NSAID users in her study as well.

Men taking acetaminophen also were included in Singer's study, and they had about the same reduction in PSA levels. But, because the number of men who took acetaminophen was low, the result was not great enough to be statistically significant, he explained.

Exactly how the medications seemingly prevent enlargement of the prostate and other problems isn't certain, St. Sauver and Singer agreed. But they speculated that the medication's anti-inflammatory action plays a major role.

However, men who take NSAIDs need to keep in mind that, if taken in excess, the drugs can cause kidney ailments and other problems, Singer warned. And too much acetaminophen has been associated with liver toxicity.

The U.S. Food and Drug Administration warns that extended use of NSAIDs can increase the chances of a fatal heart attack or stroke and also can cause ulcers or excessive bleeding in the stomach and intestines.

Because of such possibilities, "we are certainly not telling men to take NSAIDs to reduce PSA or prostate cancer risk," Singer said, despite the "good news" from the studies.

''Talk to your health-care provider about prostate health and prostate cancer screening," he advised, adding a reminder to "make sure your doctor knows what medications you are taking."

No one knows exactly why some men develop prostate cancer, and others don't. In the United States, though, almost 190,000 men are expected to be diagnosed with the disease this year, and about one in six will develop it at some point in their life, according to the American Cancer Society.

Age is the main risk factor for prostate cancer. U.S. government statistics show that the disease rarely occurs in men younger than 40 and most often strikes men older than 65.

To treat prostate cancer that has not spread beyond the gland, according to the Cancer Society, doctors most often recommend:

  • Prostatectomy, surgery to remove all or part of the prostate gland
  • Radiation, either via an external beam or implanted radioactive seeds
  • Watchful waiting, the term used to describe deferring treatment until there are signs that the cancer is progressing

And, as treatment and detection methods have improved, the survival rate for prostate cancer has been improving in the United States in recent decades, according to the National Cancer Institute.

More information

The U.S. Food and Drug Administration has more on prostate health.

Posted: June 2009


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