For benign prostate enlargement, a combination of drugs may be better
03.03.10
A combination of drugs is better than either one alone for treating benign prostatic hyperplasia or BPH, an enlargement of the prostate gland that impedes normal urinary functions, researchers reported in the journal European Urology. The study is the first to analyze such a combination of therapies, said Dr. Claus Roehrborn of the University of Texas Southwestern Medical Center in Dallas, the lead author of the report.
BPH is a common urologic condition that affects about half of men between the ages of 50 and 60 and more than 90% of those over the age of 80. The enlargement of the prostate creates pressure on the urethra, which makes it difficult to urinate. That, in turn, can lead to acute urinary retention, which produces extreme discomfort and often is associated with recurrent infections.
The two most common medications used to treat BPH are tamsulosin (best known as Flomax) and dutasteride (best known as Avodart). If they don't shrink the prostate, surgery may be necessary to reduce its volume and restore urinary flow, but that can often lead to the same complication — incontinence and impotence — encountered after prostate cancer surgery.
Source: Los Angeles Times (blog)
ASCO GU: Prostate CA Prevention Affirmed for BPH Drug
07.03.10
SAN FRANCISCO -- For men with benign prostatic hyperplasia (BPH), dutasteride (Avodart) both prevents prostate cancer and boosts the predictive power of prostate specific antigen (PSA), researchers here affirmed.
The drug was associated with 40% lower incidence of prostate cancer diagnosis than the BPH drug tamsulosin (Flomax) in at-risk men, according Leonard G. Gomella, MD, of the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia, and colleagues.
This appeared to be the result of less frequent biopsy in the dutasteride group (143 of 1,623 versus 214 of 1,611), Gomella's group reported here at the Genitourinary Cancers Symposium.
But the number of cancers confirmed when biopsy was performed -- largely driven by rising PSA -- tended to be higher on dutasteride (28% versus 24% on tamsulosin).
PSA has been criticized for missing almost as many cancers as it finds and for overdiagnosing cancer without distinguishing indolent or benign lesions.
Source: MedPage Today
ASCO GU: Novel Urine Test IDs Prostate Cancer
04.03.10
SAN FRANCISCO -- An experimental urine test may pick up prostate cancers before biopsy in high-risk men, researchers found.
The Prostate Cancer Gene 3 (PCA3) test score at the time of a negative first biopsy predicted a positive rebiopsy two years later with 79.1% specificity and 36.4% sensitivity, according to retrospective analysis of a clinical trial to be reported here at the Genitourinary Cancers Symposium.
"PCA3 may be detecting cancers that were missed by biopsy," said Jack Groskopf, PhD, of Gen-Probe San Diego, at a press conference in advance of the presentation.
The test also was a good overall predictor of the outcome of repeat biopsy, said Groskopf, whose company makes a commercial PCA3 assay approved for use in Europe, but not in the U.S outside of certified laboratories.
Serum prostate specific antigen (PSA) and percent free PSA -- markers usually used to follow men on watchful waiting -- don't correlate with future biopsy outcomes, he noted.
Source: MedPage Today
