Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

NIH Launches New Study to Compare Prostate Surgery and Drugs

17.11.2004


The Minimally Invasive Surgical Therapies (MIST) Consortium for Benign Prostatic Hyperplasia (BPH) has launched a new study to compare long-term benefits and risks of transurethral needle ablation (TUNA) and transurethral microwave thermotherapy (TUMT) to a regimen of the alpha-1 inhibitor alfuzosin and the 5-alpha reductase inhibitor finasteride. The National Institute of Diabetes and Digestive and Kidney Diseases at NIH, part of the Department of Health and Human Services, is investing more than $15 million in the study.



TUNA and TUMT use heat to destroy part of the enlarged prostate to improve urine flow and symptoms. Early studies suggest that these procedures reduce the occurrence of erection or bladder control side effects, which occur more often with the traditional surgery for BPH, known as transurethral resection of the prostate (TURP). TUNA and TUMT are said to be minimally invasive in part because they typically are done with local anesthesia and men go home the same day, whereas TURP requires general anesthesia and an overnight hospital stay. As for drug therapy, a recently published large randomized study showed that a regimen of finasteride (Proscar) and the alpha-1 inhibitor doxazosin (Cardura) prevents progression of BPH in a significant percentage of symptomatic men and it helps men at high risk avoid surgery.

“It’s easy to see why drug therapy, TUNA and TUMT have been embraced by many urologists and patients,” said Leroy M. Nyberg Jr., Ph.D., M.D., director of NIDDK’s urology trials. “Yet, we don’t know which treatment is more effective in the long run and, for the most part, who would be better served by the drug combination versus one of the minimally invasive therapies.”


By July 2006, researchers plan to have recruited and randomly assigned more than 700 men with moderate to severe symptoms and no prior prostate surgery to one of the three MIST therapies. The men, age 50 and over, will be followed closely for 3 to 5 years, until about July 2009, to see who develops urinary retention, urinary tract infection or unacceptable incontinence after treatment; who needs more treatment; and whose symptoms don’t improve by at least 30 percent after treatment.

Consortium members recruiting patients are Baylor College of Medicine in Houston; Columbia University in New York City; Mayo Clinic in Rochester, Minn.; Medical College of Wisconsin in Milwaukee; Northwestern University in Chicago; University of Colorado Health Sciences Center in Denver; and the University of Texas Southwestern Medical Center in Dallas. George Washington University Biostatistics Center in Rockville, MD, provides overall coordination for the study and data collection and analysis. For contact information visit www.mistbph.org.

BPH is increasingly common after age 50. Mild symptoms may wax and wane on their own, but Nyberg predicts that as more Baby Boomers cross into their 50s, physicians are likely to start seeing more men who are up frequently at night using the bathroom, a typical symptom of BPH along with embarrassing episodes of needing to go right away (urgency), daytime frequency, and occasional episodes of unavoidable wetting. Over time, the progressive symptoms associated with BPH can have a significant impact on quality of life for the individual as well as his close family members.

In 2000, BPH accounted for about 8 million office visits, 117,000 trips to emergency rooms, 105,000 hospital stays and 87,400 TURPs. BPH also cost patients and insurers about $1.1 billion, without considering nutritional supplements and 2.2 million prescriptions, according to NIDDK’s Urologic Diseases in America interim compendium, released this spring.

MIST will also compare TUNA to TUMT and seeks to identify men best suited for each of the three therapies. Changes in sexual function, ejaculation, bladder changes, PSA, prostate size and shape, and ratio of various prostate tissues; and pain before, during and after surgery, among other parameters, will be tracked in search of characteristics predicting likely outcome and effectiveness of therapies. “Having a protocol to fit the man to the therapy without having to try each treatment along the way should translate into lower costs and more-satisfied patients,” said John W. Kusek, Ph.D., a clinical trials expert at NIDDK.

MIST therapies are approved by FDA, but relative benefits, risks and cost have never been compared. Further, there have been few rigorously conducted randomized trials of the minimally invasive surgical approaches. “Previous studies of TUMT and TUNA haven’t looked at side-effects and symptom relief long-term but, after we’ve finished MIST, men and their doctors should be a lot smarter about the options,” said Kusek.

Other support for MIST comes from Diagnostic Ultrasound, Bothell, Washington; Urologix Inc. and Medtronic, both in Minneapolis; Merck & Co., Whitehouse Station, New Jersey; and Sanofi-Synthelabo Inc., New York.

Mary Harris | EurekAlert!
Further information:
http://www.nih.gov

More articles from Studies and Analyses:

nachricht A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg

nachricht Urbanization to convert 300,000 km2 of prime croplands
27.12.2016 | Mercator Research Institute on Global Commons and Climate Change (MCC) gGmbH

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Water - as the underlying driver of the Earth’s carbon cycle

17.01.2017 | Earth Sciences

Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

17.01.2017 | Materials Sciences

Smart homes will “LISTEN” to your voice

17.01.2017 | Architecture and Construction

VideoLinks
B2B-VideoLinks
More VideoLinks >>>