The latter can occur in a variety of settings, depending on the desired result. Some preventive measures, such as polio vaccines, are administered to the general population. Others, such as cholesterol-lowering drugs, are given only to people with an increased risk for acquiring coronary artery disease. Scientists are now studying several agents that may one day be used to prevent prostate cancer, but they have yet to decide what will be chosen and who should receive it. Most likely, men who eventually receive preventive therapy will be those at increased risk of developing cancer.
Prostate cancer seems the ideal disease to become the target of a prevention program.
It grows slowly and there is a long interval between when the tumor is small and nonaggressive and when it is large and aggressive, thus providing an ample window of opportunity when preventive therapy can be employed. Prostatic carcinoma is unique because of its high number of microscopic cancers. As we know, once most men reach a certain age, they have some degree of cancer in their prostates. Preventive agents could block those tumors from progressing to a dangerous stage. Despite the countless considerations that must be weighed when new medications are developed, the single factor that ultimately determines whether a drug is adopted is its toxicity.