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 Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

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: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Transport of molecular motors into cilia

28.03.2017 | Life Sciences

A novel hybrid UAV that may change the way people operate drones

28.03.2017 | Information Technology

NASA spacecraft investigate clues in radiation belts

28.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>