New Therapy May Shrink Enlarged Prostate With Fewer Side Effects: Study

MONDAY, March 24, 2014 (HealthDay News) -- A new noninvasive procedure may bring long-term relief from symptoms caused by an enlarged prostate, a new study suggests.

As men age, the prostate gland grows larger and may begin to press on the urethra. Enlarged prostate affects more than half of men by age 60 and causes symptoms such as frequent urination, weak urine stream and a persistent feeling of having to urinate.

Surgery is the standard treatment for the condition, but can cause complications such as sexual dysfunction and impotence, experts note.

The new treatment is called prostate artery embolization. "Prostate artery embolization is a promising therapy that has been performed outside the United States to improve men's symptoms," explained Dr. Man Hon, chief of interventional radiology at Winthrop University Hospital in Mineola, N.Y.

"This procedure works by closing the blood supply to the prostate," said Hon, who was not involved in the new study. "As a result, the prostate shrinks in size, causes less blockage, and the symptoms improve."

The study was conducted in Portugal and included nearly 500 men, aged 45 to 89, with enlarged prostate -- formally called benign prostatic hyperplasia -- who underwent prostate artery embolization.

Improvements in symptoms were reported by 87 percent of men three months after the procedure, 80 percent after 18 months, and 72 percent after three years. The procedure did not cause sexual dysfunction or impotence, according to the findings, which were slated for presentation on Monday at the annual meeting of the Society of Interventional Radiology (SIR), in San Diego.

"The results of prostate artery embolization (PAE) are similar to surgery but with fewer complications," study author Dr. Martins Pisco, director of radiology at Saint Louis Hospital in Lisbon, said in a meeting news release. "Patients are discharged three to six hours after the treatment with most of the individuals we've treated noting almost immediate symptom relief."

"I believe PAE could eventually become standard treatment for enlarged prostate," he added.

However, Dr. James Spies, president elect of SIR, stressed that further studies are needed before the procedure could become widely available. Also, studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Another expert agreed that more study is needed. Dr. Manish Vira is director of the Fellowship Program in Urologic Oncology at The Arthur Smith Insitute for Urology in New Hyde Park, NY. He pointed out that the Portuguese study was not designed to compare the success rate of embolization to that of other treatments.

However, Vira added that "the results are especially significant given the very low complication rate and no incontinence. If these results are replicated in the ongoing U.S. trials, then prostate artery embolization will become an attractive treatment option" for men with enlarged prostate who have not responded well to other treatments.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCES: Manish A. Vira, M.D, director, Fellowship Program in Urologic Oncology, The Arthur Smith Institute for Urology, New Hyde Park, NY; Man Hon, M.D, chief, interventional radiology, Winthrop University Hospital, Mineola, NY; Society of Interventional Radiology, annual meeting news release, March 24, 2014

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Study Ties Y Chromosome Variations to Prostate Cancer Risk

FRIDAY, Oct. 25 (HealthDay News) -- Men with certain inherited variations in their Y chromosome may have a higher risk of prostate cancer, according to a large new study.

Researchers from the University of Utah School of Medicine said the identification of these genetic mutations could help scientists develop tests to determine men's risk for developing the disease and also improve prostate cancer treatments.

In conducting the study, the researchers used the Utah Population Database, which dates back to the 1800s and identifies more than 6.5 million people, spanning 15 generations. The study was narrowed down to 1.25 million men who had at least two parents, four grandparents and six or eight great-grandparents also in the database.

All of the men who did not have a father in the database were labeled as "founders" and assigned a specific Y chromosome identification (YID). Founders' sons, grandsons and great-grandsons also were assigned the same YID. Of these groups, nearly 260,000 had at least two men sharing the same Y chromosome.

The men's genealogical and medical records also were linked to the Utah Cancer Registry, enabling the researchers to determine which of the men developed prostate cancer.

The researchers said that since most of the Y chromosome does not recombine during cell division, it is passed almost entirely unchanged from father to son.

"As a result, each male resident of Utah shares the Y chromosome of his father and his father's father and so on," study leader Lisa Cannon-Albright said in a news release from the American Society of Human Genetics.

"This provided the ability to estimate the risk for prostate cancer in independent Y chromosomes represented in Utah," said Cannon-Albright, chief of the genetic epidemiology division at the University of Utah School of Medicine.

Once the researchers estimated the number of prostate cancer cases expected to occur in each YID group, they compared this estimate to the actual number of prostate cancers.

Focusing on 1,000 YID groups that included between about 200 and 2,300 men, the study revealed the prostate cancer incidence was significantly higher than expected in 73 specific Y chromosome groups.

The researchers said that in one YID group of nearly 9,800 men, they predicted that about 45 prostate cancer cases would have occurred. When they compared their estimate to the state's cancer registry, they found that 65 men in the group had actually been diagnosed with prostate cancer.

A separate group of about 500 men revealed that 26 had prostate cancer. The researchers had estimated, however, that about 10 cases would develop among this group.

Among the men who did not share the Y chromosome of the founder, 39 developed prostate cancer. This rate was not statistically different from the 36 cases of the disease predicted by the researchers, who concluded that there is a Y chromosome-linked risk for prostate cancer that is not seen among men who do not share a common Y chromosome.

The study findings were scheduled for presentation Friday at the American Society of Human Genetics meeting, in Boston. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Society of Human Genetics, news release, Oct. 25, 2013

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