Common practice is to treat men with advanced prostate cancer with androgen inhibition therapy (ADT) with or without antiandrogens (Casodex). Most of our prostate cancer will progress and develop into androgen-independent prostate cancer despite our achieving castrate testosterone levels.

Dutasteride, a 5-alfa-reductase inhibitor, is commonly used in the treatment of benign prostatic hyperplasia (BPH). Additional, despite the controversy around its use, some physicians use it as a third drug along with ADT2, ADT3.

Recently a prospective study was reported that evaluated the clinical utility of using dutasteride, in the treatment of hormone refractory prostate cancer. In this study 8 men who were hormone refractory were evaluated prospectively. After antiandrogen withdrawal and then after experiencing the expected increase in PSA, 5 of the men patients were given docetaxel plus prednisone and 3 of them received ketoconazole plus hydrocortisone. Additional all 8 of them were given 2 tablets of 0.5 mg of dutasteride.

The researchers defined a positive therapeutic response as a >50% reduction in PSA or a 75% reduction of PSA at 4 weeks after the start of combined protocol. The mean duration of the study follow-up was 9 months with a range of 21-24 months. A reduction >50% or >75% in PSA (positive therapeutic response as defined by the researcher) was noted