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Urology/Prostate enlargment and Avodart


Dear Dr. Leslie, I have an enlarge prostate (71gr, Ultrasound on May the 25th), and doctors normally prescribe Avodart to me, although so far I don't have a problem having to go to the bathroom too often (once at night, only). Right now I am not taking Avodart. Since the manufacturers of Avodart declare that this medicine can in certain cases cause prostate cancer, should I wait to take Avodart until a real urge to the bathroom arises or should I start before the problem appears? In the case I have to start taking Avodart right now, should I take some omega-3 supplement with it to minimize the risk of cancer? Thank you very much.


You have an enlarged prostate which is not yet causing much urinary trouble.  Avodart can effectively shrink the prostate about 25% if taken regularly.  There was a report that avodart and similar medications might slightly increase the risk of some prostate cancers, but most experts now believe that this is not the case and that avodart only improves the identification of such tumors.  Therefore, we would recommend that you continue the medicatino as prescribed but talk to your physicians about these concerns.

There is no solid evidence that omega-3 supplements helps with prostate cancer risk as results from various studies are often conflicting.  Here is a summary of the latest summary on dietary factors and prostate cancer.

BMC Med. 2015 Jan 8;13:3. doi: 10.1186/s12916-014-0234-y.

Nutrition, dietary interventions and prostate cancer: the latest evidence.

Lin PH1, Aronson W, Freedland SJ.

Prostate cancer (PCa) remains a leading cause of mortality in US men and the prevalence continues to rise world-wide especially in countries where men consume a 'Western-style' diet. Epidemiologic, preclinical and clinical studies suggest a potential role for dietary intake on the incidence and progression of PCa. 'This minireview provides an overview of recent published literature with regard to nutrients, dietary factors, dietary patterns and PCa incidence and progression. Low carbohydrates intake, soy protein, omega-3 (w-3) fat, green teas, tomatoes and tomato products and zyflamend showed promise in reducing PCa risk or progression. A higher saturated fat intake and a higher β-carotene status may increase risk. A 'U' shape relationship may exist between folate, vitamin C, vitamin D and calcium with PCa risk. Despite the inconsistent and inconclusive findings, the potential for a role of dietary intake for the prevention and treatment of PCa is promising. The combination of all the beneficial factors for PCa risk reduction in a healthy dietary pattern may be the best dietary advice. This pattern includes rich fruits and vegetables, reduced refined carbohydrates, total and saturated fats, and reduced cooked meats. Further carefully designed prospective trials are warranted.  


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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