Wait! Don't Cut!

For the 10 million mostly older American men who suffer from enlargement of the prostate, the condition brings frequent and sometimes painful urination and is usually treated by surgical removal of the gland. But surgery carries the risk of impotence and loss of bladder control -- along with the unpleasantness of the operation itself. That explains the fanfare with which Merck & Co. announced it had just won approval from the Food and Drug Administration for a new drug, Proscar, that can shrink prostates without surgery.

Can is the operative word. Only one-third of the subjects in clinical trials showed a clear benefit from taking Proscar, while another third showed limited improvement and the rest none at all. Moreover, Proscar can interfere with a blood test that is widely used for early detection of prostate cancer, so doctors have to be doubly alert. Still, considering that prostate surgery sometimes has to be repeated a few years later, Proscar (and a variety of other drugs being tested for FDA approval) could mean good news for patients -- and big profits for Merck.