Nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 selective inhibitors for prostate cancer chemoprevention

J Urol. 2004 Feb;171(2 Pt 2):S59-62; discussion S62-3. doi: 10.1097/01.ju.0000107839.06670.27.


Purpose: There is increasing evidence that using nonsteroidal anti-inflammatory drugs decreases the incidence of clinically apparent prostate cancer. We review the potential mechanisms of cancer reduction with cyclooxygenase (COX)-2 inhibitors and the clinical evidence suggesting their effectiveness.

Materials and methods: A literature review using MEDLINE was conducted of animal, observational, and clinical studies of nonsteroidal anti-inflammatory drugs in cancer, specifically prostate cancer. The Physician Data Query database was searched for current studies of COX-2 inhibitors for chemoprevention of prostate cancer.

Results: Research suggests that COX-2 inhibiting medications are determinants in lower cancer incidence rates. Other studies have suggested up-regulation of the COX-2 enzyme in prostate cancer compared with normal prostate tissue. Selective COX-2 inhibitors are currently under study to evaluate their potential roles in preventing prostate cancer in high-risk patients (rofecoxib) or the recurrence of bladder cancer (celecoxib). Agents such as exisulind, which is a selective apoptotic antineoplastic drug, are also under investigation.

Conclusion: COX-2 inhibitors are promising agents for the chemoprevention of prostate cancer but further research is needed.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Anticarcinogenic Agents / therapeutic use*
  • Arachidonic Acid / metabolism
  • Cyclooxygenase 2
  • Cyclooxygenase 2 Inhibitors
  • Cyclooxygenase Inhibitors / pharmacology
  • Cyclooxygenase Inhibitors / therapeutic use*
  • Humans
  • Isoenzymes / antagonists & inhibitors
  • Male
  • Membrane Proteins
  • Prostaglandin-Endoperoxide Synthases
  • Prostatic Neoplasms / physiopathology
  • Prostatic Neoplasms / prevention & control*


  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticarcinogenic Agents
  • Cyclooxygenase 2 Inhibitors
  • Cyclooxygenase Inhibitors
  • Isoenzymes
  • Membrane Proteins
  • Arachidonic Acid
  • Cyclooxygenase 2
  • PTGS2 protein, human
  • Prostaglandin-Endoperoxide Synthases