Hudak et al side effects were assessed every 4 months throughout the finasteride. The role of dutasteride in the prevention duration of the study. The drop out rate was higher with of prostate cancer remains to be proven. Finally, while placebo (42%, p<0.001) versus ﬁnasteride (34%). Men preliminary data indicate a possible role of 5AR inhibitors in the placebo group were more likely to drop out due to in various forms of multimodal therapy for prostate cancer, lack of improvement or worsening of disease or to receive there have been no deﬁnitive studies demonstrating improved medical or surgical therapy for BPH. Statistically signiﬁcant survival with its use in any regimen. The role of 5AR drug-related adverse effects in the ﬁnasteride group included inhibitors in the management of prostate cancer therefore sexual dysfunction, breast enlargement/tenderness, and rash. remains unknown. However, the risk of these adverse effects was relatively low compared with placebo. Rates of decreased libido and impotence were different only during the ﬁrst year. There was no difference in the rates of serious adverse events (McConnell et al 1998). During seven years of finasteride therapy versus placebo in the 18 882 men enrolled in the PCPT, similar tolerability rates were seen. In the placebo group, 28.9% of men temporarily discontinued therapy sometime during the 7 year study, compared with 36.8% in the ﬁnasteride group (p<0.001). Reduced ejaculate volume, erectile dysfunction, loss of libido, and gynecomastia were more common in the ﬁnasteride group (p<0.001 for each comparison) but the overall risk for these adverse effects remained low compared with placebo. There was one case of breast cancer in each arm of the trial. The death rate (all-cause and prostate cancer) was not signiﬁcantly different between the two groups (Thompson et al 2003). Despite the dual isotype blockade of 5AR and subsequent lower serum and prostatic levels of DHT, the tolerability of dutasteride is similar to that of ﬁnasteride. A 2 year study of dutasteride for the treatment of BPH revealed rates of impotence, decreased libido, ejaculation disorder, and gynecomastia similar to that of ﬁnasteride. The drug-related side-effects were transient with no statistically significant difference noted at 2 years. (Roehrborn et al 2002). Summary and conclusions: 5AR inhibitors are effective for the medical management of BPH and their impact on the hormonal physiology of the prostate with relatively-low toxicity has led to studies of their use for the prevention and treatment of adenocarcinoma of the prostate. In spite of the fact that ﬁnasteride is the only agent shown to prevent prostate cancer in a randomized clinical trial, there is not widespread acceptance of its use for the prevention of this malignancy. 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