The Fitness

An on-line training module for GP’s and healthcare professionals to increase awareness of Parkinson’s disease, has attracted over 3,000 participants from as far away as New Zealand.

Parkinsons’ Disease Society’s (PDS) 2007 membership survey showed that 50% of people with Parkinson’s believed there was a lack of understanding from GP’s and professionals about how to spot and treat the condition.

As a result the PDS commissioned BMJ Learning to produce an on-line module to help users increase their knowledge and skills in how to care for patients, and how to increase knowledge and skills to assess and refer people with suspected Parkinson’s Disease.

Daiga Heisters, PDS National Education Adviser, comments:

“We were delighted with the response to the training. The target of 400 participants to complete the module in the first 6 months was exceeded with over 3,000 completing in the first 5 months. This reflects the interest health care professionals have in increasing their knowledge on the management of Parkinson’s and the effectiveness of BMJ Learning’s marketing campaign”.

Alveena Igbal, from Derby City PCT who took the course, said:

“As our elderly population increases so does the challenge to deal with chronic disabling conditions like Parkinsonism. In this context I have found the BMJ Learning module very useful.”

Dr Amal Paul from Pudsey, Leeds, adds:

” As a G.P. I have to look after a few patients with Parkinson’s disease, and the need for further care management was more imperative for me when someone close to me was diagnosed. The module was very interesting, designed for adult learning, interactive, and educational. My knowledge and skills have definitely improved and the module was a big impetus for further study”.

This module complements the work of the PDS Education Training Officers currently working with GPs and other healthcare professionals throughout the UK at a local level.

Due to the success of the pilot, a second learning module is being launched, focusing on non- motor symptoms of Parkinson’s such as depression and sleep disorders.

For more information about Parkinson’s visit: parkinsons

For more information about BMJ Learning visit bmjlearning.

The Parkinson’s Disease Society (PDS) is the leading authority in the UK on the condition and a world leader in research. We campaign for a better quality of life for people with Parkinson’s wherever they live in the UK. We provide expert information on all aspects of Parkinson’s and a local support network for people with Parkinson’s, their carers, families and friends. We are the UK’s leading non-commercial funder of research into the cause, prevention and improved management of Parkinson’s and are confident that our work will help lead to a cure. We are totally dependent on voluntary donations.

Parkinson’s Disease Society

Rutgers researchers have found that the curry spice turmeric holds real potential for the treatment and prevention of prostate cancer, particularly when combined with certain vegetables.

The scientists tested turmeric, also known as curcumin, along with phenethyl isothiocyanate (PEITC), a naturally occurring substance particularly abundant in a group of vegetables that includes watercress, cabbage, winter cress, broccoli, Brussels sprouts, kale, cauliflower, kohlrabi and turnips. “The bottom line is that PEITC and curcumin, alone or in combination, demonstrate significant cancer-preventive qualities in laboratory mice, and the combination of PEITC and curcumin could be effective in treating established prostate cancers,” said Ah-Ng Tony Kong, a professor of pharmaceutics at Rutgers, The State University of New Jersey.

The discovery was announced in the Jan. 15 issue of the journal Cancer Research by Kong and his colleagues at Rutgers’ Ernest Mario School of Pharmacy.

Prostate cancer is the second leading cause of cancer death in men in the United States, with a half-million new cases appearing each year. The incidence and mortality of prostate cancer have not decreased in past decades despite tremendous efforts and resources devoted to treatment. This is because advanced prostate cancer cells are barely responsive even to high concentrations of chemotherapeutic agents or radiotherapy.

The authors noted that in contrast to the high incidence of prostate cancer in the United States, the incidence of this disease is very low in India. This has been attributed to the dietary consumption of large amounts of plant-based foods rich in phytochemicals – nonnutritive plant chemicals that have protective or disease-preventive properties.

Consequently, scientists have been investigating intervention options based on compounds found in edible and medicinal plants. They have had some success, and a majority of patients with prostate cancer are now combining the conventional therapies with these compounds as alternative, supplementary or complementary medications.

For Kong’s study, researchers used mice bred so that their immune systems would not reject foreign biological material and injected the mice with cells from human prostate cancer cell lines to grow tumors against which the compounds could be tested.

“Despite convincing data from laboratory cell cultures, we knew little about how PEITC and curcumin would perform in live animals, especially on prostate cancer,” Kong said. “So we undertook this study to evaluate how effective PEITC and curcumin might be – individually and in combination – to prevent and possibly treat prostate cancer.”

The researchers injected the mice with curcumin or PEITC, alone or in combination, three times a week for four weeks, beginning a day before the introduction of the prostate cancer cells. They found the injections significantly retarded the growth of cancerous tumors. Using PEITC and curcumin in tandem produced even stronger effects.

The group went on to evaluate the therapeutic potential of curcumin and PEITC in mice with well-established tumors, and the results showed that PEITC or curcumin alone had little effect, whereas the combination of curcumin and PEITC significantly reduced tumor growth.

The paper, “Combined Inhibitory Effects of Curcumin and Phenethyl Isothiocyanate on the Growth of Human PC-3 Prostate Xenografts in Immunodeficient Mice,” is available at cancerres.aacrjournals.

The authors are Tin Oo Khor, Young-Sam Keum, Wen Lin, Jung-Hwan Kim, Rong Hu, Guoxiang Shen, Changjiang Xu, Avanthika Gopalakrishnan, Bandaru Reddy, Xi Zheng, Allan H. Conney and Ah-Ng Tony Kong, all from Rutgers.

Joseph Blumberg
blumbergur.rutgers.edu
Rutgers, the State University of New Jersey
rutgers.edu

Two variations in the gene for insulin-like growth factor I (IGF-1) are linked to an increased risk of prostate cancer, according to research performed by scientists from the Keck School of Medicine of the University of Southern California, the Broad Institute of Harvard and MIT, and the University of Hawaii.

“Our results suggest that inherited variation in IGF1 may play a role in prostate cancer risk,” write the researchers in a paper published in the January 18, 2006, issue of the Journal of the National Cancer Institute.

USC scientists on this research team included: Iona Cheng, who was first author on the paper; Daniel Stram, Ph.D., professor of preventive medicine at the Keck School and the USC/Norris Comprehensive Cancer Center; Malcolm Pike, Ph.D., professor preventive medicine at the Keck School and USC/Norris; and Keck School of Medicine Dean Brian E. Henderson, M.D., who is also a distinguished professor in preventive medicine and neurology and the Kenneth T. Norris Jr. Chair in Cancer Prevention.

Cheng and her colleagues were able to tease out the relevant gene variations using data from the large Multiethnic Cohort study, for which Henderson is co-principal investigator. This population-based cohort study has collected data on more than 215,000 men and women from Los Angeles and Hawaii over the past decade.

From this cohort and information from cancer registries in California and Hawaii, the scientists were able to identify 2320 men who had developed prostate cancer and match them with 2290 men who did not have a prostate cancer diagnosis. This large population, the study’s authors noted, provided “substantial [statistical] power to detect modest genetic effects.”

The team knew that high circulating levels of IGF-1 had been linked by previous studies to an increase in prostate cancer risk, and so they focused on that gene and its single-nucleotide polymorphisms (SNPs): tiny point variations in the DNA code for a particular gene. What they found was that several SNPs across the gene were linked to an increased risk of prostate cancer, and two particular SNPs were identified that could account for the genetic associations they observed. Ten percent of the prostate cancer cases in this study could be explained by the variation in DNA sequence of these two polymorphisms.

Because of the ethnic diversity in the cohort’s population–included in the group are African Americans, Hawaiians, Japanese Americans, Latinos and whites–the researchers were also able to look at the risk associated with the two SNPs across the five different ethnic groups. As it turned out, the increase in risk was the same throughout all the sub-groups, “suggesting that the inherited variation in IFG1 behaves similarly among ancestral groups and shares an overall biologic effect,” the researchers observed.

“Our study critically evaluates the possibility of false positive results, and important issue faced by genetic association studies, and provides strong support for the involvement of the IGF pathway in the development of prostate cancer,” Cheng noted. “By identifying the mechanisms in which inherited differences in IGF1 influence disease, we will further advance our understanding of prostate cancer biology and disease susceptibility.”

Iona Cheng, Daniel O. Stram, Kathryn L. Penney, Malcolm Pike, Loic Le Marchand, Laurence N. Kolonel, Joel Hirschhorn, David Altshuler, Brian E. Henderson, Matthew L. Freedman, “Common Genetic Variation in IGF-1 and Prostate Cancer Risk in the Multiethnic Cohort.” Journal of the National Cancer Institute, Vol. 98, No. 2, January 18, 2006.

Kathleen O’Neil
kathleen.oneilusc.edu
University of Southern California
usc.edu

A new study suggests that genetic variation in the insulin-like growth factor 1 (IGF1) gene may be associated with the risk of prostate cancer.

Earlier studies have shown that men with the highest circulating levels of IGF-I, the product of the IGF1 gene, are at an increased risk of developing prostate cancer. It was not known, however, if variations in the IGF1 gene were associated with an increased risk of developing prostate cancer.

Matthew Freedman, M.D., at the Dana-Farber Cancer Institute and Broad Institute of Harvard and MIT in Cambridge, and colleagues examined specific variations in the IGF1 gene called single nucleotide polymorphisms (SNPs) largely derived from a public SNP database in 4610 individuals with and without prostate cancer. They identified two specific polymorphisms on the IGF1 gene that were associated with an increased risk of prostate cancer. “Our results suggest that inherited variation in IGF1 may play a role in prostate cancer risk,” they write.

The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at jncicancerspectrum.oxfordjournals.

Ariel Whitworth
jncimediaoxfordjournals
Journal of the National Cancer Institute
jncicancerspectrum.oupjournals

The next five years will herald massive growth for minimally invasive prostate cancer devices in several emerging markets, with high intensity focused ultrasound (HIFU) technology leading the way. By 2010, the Asian and Latin American markets for brachytherapy seeds, cryoablation, and HIFU devices will gross over $25 million in revenue-more than 3 times the market value in 2005.

According to a recent report by Millennium Research Group, prostate cancer rates are rising sharply due to the aging population and changing lifestyles. In Asia, especially, a spike in prostate cancer cases is linked to a move away from traditional diets toward more Western fare. As rates of prostate cancer rise, so too will the interest in minimally invasive treatments. Much, if not most, of the growth in this sector will take place in rapidly industrializing countries in the Far East and Latin America.

Although it has yet to receive approval for commercial use in the US, HIFU treatment for prostate cancer is already tapping into a rapidly growing market in China and Mexico. The Chinese government is heavily funding research and installation of this up-and-coming technology, and a new generation of Chinese urologists is being trained to perform these procedures.

In Mexico, the growth of HIFU has been overwhelming, spurred by a public that is increasingly educated about options other than radical prostatectomy and a willingness to explore new treatments.

Meanwhile, cryoablation will also enjoy spectacular growth rates; however, this will not be attributed to demand for prostate cancer. Instead this market will be bolstered by its minimally invasive application for renal tumors, which is proving to be a big draw in Asia where kidney cancer rates are the highest in the world.

Millennium Research Group’s Emerging Markets for Prostate Cancer Devices 2006 report includes in-depth analysis on the Chinese, Indian, Singaporean, South Korean, Taiwanese, Brazilian, and Mexican markets for brachytherapy seeds, cryoablation, and HIFU. The report includes insights into active competitors such as C.R. Bard (BCR), EDAP-TMS, Endocare (ENDO), Focus Surgery, Ningbo Junan, and Oncura.

A leading source of competitive intelligence, MRG is now the largest provider of medical device market research in the world. Located in Toronto, Canada, MRG covers global markets and has pioneered reporting of numerous emerging products.

MILLENNIUM RESEARCH GROUP
mrg

The 3rd Analysis of the Early Prostate Cancer Trial (EPC) Programme gives additional confirmation that bicalutamide 150mg is a proven treatment option for men with locally advanced prostate cancer.

New data published in the February 2006 edition of the British Journal of Urology International (BJUI) confirm that bicalutamide 150mg improves the chance of survival by 35 per cent (hazard ratio = 0.65; 95% CI = 0.44 to 0.95, p = 0.03)1 in men with locally advanced prostate cancer (when the disease has spread into the capsule of the prostate or through the prostate into the surrounding tissue) when given bicalutamide 150mg as adjuvant to radiotherapy compared to radiotherapy alone. Bicalutamide 150mg is the only anti-androgen for which this has been shown.1

Also the data from the largest ever treatment study in prostate cancer show that in locally advanced disease, bicalutamide 150mg adjuvant to radiotherapy or radical prostatectomy reduces the risk of disease progression by 31 per cent (hazard ratio = 0.69; 95% CI = 0.58 to 0.82, p < 0.001) leading to a significant survival benefit of 35 per cent when used as adjuvant to radiotherapy.1,[ii] In addition, in men with locally advanced prostate cancer, when bicalutamide 150mg was given as monotherapy (alone) there was a 40 per cent reduction in risk, which extended survival free of progression by a median of 2.9 years, showing a trend towards improved survival.2

Commenting on the data, Dr Heather Payne, Consultant in Clinical Oncology, Middlesex Hospital, London stated: “A diagnosis of prostate cancer is truly devastating for the patient. A treatment that both extends a patient’s life and delays the recurrence of the disease whilst maintaining a man’s quality of life is the ultimate goal when managing this condition. This new data from the EPC Trial Programme demonstrates that bicalutamide 150mg meets these vital needs and will have this effect for men with locally advanced prostate cancer.”

Results also confirm that treatment with bicalutamide 150mg significantly reduces the risk of bone metastases by 36 per cent in men with locally advanced prostate cancer compared to watchful waiting and by 23 per cent when added to radiotherapy or radical prostatectomy alone.2 Bone metastases are a symptom of disease progression and can include bone and back pain that can cause difficulty in walking and carrying out other daily activities and in more advanced cases can lead to spinal cord compression. By delaying disease progression, bicalutamide 150mg helps men with locally advanced prostate cancer to maintain an active lifestyle.

Patients with locally advanced prostate cancer have a significant risk of their disease progressing, seriously impacting quality of life. Therefore, therapies that improve progression-free survival whilst allowing patients to maintain a normal lifestyle are vital in managing the disease. In addition to improving progression-free survival, bicalutamide 150mg alone demonstrates equal efficacy to castration and provides patients with significant quality of life benefits.[iii] Compared with castration, bicalutamide 150mg provides better maintenance of physical capacity and sexual interest.3,[iv] Bicalutamide 150mg also maintains bone mineral density, which is lost with castration and is associated with an increased risk of fractures.[v]

The EPC Trial Programme has followed 8,113 patients for an average of 7.4 years in 23 different countries. Patients will continue to be followed up for both disease progression and survival for a minimum period of 10 years after the last patient was enrolled into the study.

The 3rd Analysis of the EPC Programme gives additional confirmation that bicalutamide 150mg is a proven treatment option for men with locally advanced prostate cancer delaying disease progression.

In the UK, bicalutamide (Casodex) 150 mg is indicated for patients with locally advanced prostate cancer (T3-T4, any N, MO; T1-T2, N+, MO). Bicalutamide (Casodex) 150mg is indicated as immediate therapy either alone or as adjuvant to treatment by radical prostatectomy or radiotherapy. Bicalutamide (Casodex) 150mg is also indicated for the management of patients with locally advanced, non-metastatic prostate cancer for whom surgical castration or other medical intervention is not considered appropriate or acceptable.[vi]

– When the prostate cancer has spread into the capsule of the prostate or through the prostate into the surrounding tissue, it is described as being ‘locally advanced’

– Bicalutamide (Casodex) 150mg is the leading anti-androgen in the locally advanced prostate cancer market (disease that has spread to organs adjacent to the prostate gland).

– Bicalutamide (Casodex) 150mg is a non-steroidal anti-androgen, which blocks the action of androgens, such as testosterone and prevents the stimulation of prostate tumour growth.

– Bicalutamide (Casodex) 50mg is used as a combination treatment (with surgical or medical castration) for advanced prostate cancer

– Watchful Waiting is a type of prostate cancer management where no surgical or medical intervention is pursued immediately, but the prostate cancer is watched by the doctor using regular PSA blood tests and digital rectal examinations. Active treatments are delayed until the cancer produces troublesome symptoms. In watchful waiting, the doctor balances the impact of treatments upon a patient’s quality of life against the symptoms produced by the disease.

– Prostate cancer is the most common cancer to be found in elderly men in the UK. Over 30,000 men in the UK alone are diagnosed with prostate cancer each year and prostate cancer has overtaken lung cancer to become the most common cancer for men in the UK. Prostate cancer is the second biggest cause of death from cancer in men in the UK with around 10,000 deaths each year.[vii]

About AstraZeneca
www.astrazeneca

AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of prescription pharmaceuticals and the supply of healthcare services. It is one of the world’s leading pharmaceutical companies with healthcare sales of over $21.4 billion and leading positions in sales of gastrointestinal, oncology, cardiovascular, neuroscience and respiratory products. AstraZeneca is listed in the Dow Jones Sustainability Index (Global) as well as the FTSE4Good Index.

‘Casodex’ is a trademark of the AstraZeneca group of companies.

[i] McLeod et al. Early Prostate Cancer Trial Programme. Br J Urol Int. 2006 Feb; 97: 247-254
[ii] AstraZeneca data on file
[iii]Iversen, P, et al. J Urol 2000; 164: 1579-1582
[iv] Sieber PR, Keiller DL, Kahnoski RJ et al Bicalutamide 150 mg maintains bone mineral density during monotherapy for localized or locally advanced prostate cancer Urology 2004; 171: 2272-6.
[v] Shahinian et al. Risk of Fracture after Androgen Deprivation for Prostate Cancer. NEJ Med, 2005.
[vi] Bicalutamide (Casodex) 150 mg. Summary of Product Characteristics. www.medicines
[vii] England: Office for National Statistics (ONS) from data supplied by the regional cancer registries in England. Scotland: Information and Statistics Division of the Directorate of Information Services NHS in Scotland. Wales: Welsh Cancer Intelligence and Surveillance Unit. Northern Ireland: Northern Ireland cancer Registry.

astrazeneca

The men most at risk for aggressive prostate cancer – black men with a family history – are the least likely to get screening even during peak ages of risk, researchers say.

Only 25 percent of black men during peak ages of 60-69 are screened using the common blood test that measures prostate specific antigen levels and 36 percent get annual digital rectal exams, according to a study published in the Feb. 15 issue of Cancer.

Black males are diagnosed with prostate cancer at an average age of 65.

Just under 50 percent of all high-risk black males get blood tests and 38 percent get physical exams. Sixty-five percent of black males without a family history get the blood test and 45 percent get physical exams. By comparison, 81 percent of white males age 60-69 get blood tests and 68 percent get physical exams.

“Healthy black men who have several first-degree relatives with prostate cancer are much less likely to have ever gotten a prostate screening than black men without a family history and white men in the general population,” says Dr. Sally Weinrich, a nursing professor and Georgia Cancer Coalition Distinguished Cancer Scholar. “However, these are the men who have a higher-than-average risk because of their positive family histories. Hereditary forms of prostate cancer are usually diagnosed at an earlier age than non-hereditary prostate cancer.”

Dr. Weinrich and her husband, Dr. Martin Weinrich, an MCG biostatistician, identified black males with positive family histories through the national African American Hereditary Prostate Cancer Study, funded by the National Institutes of Health and concluded in 2004. Comparable black males and white males were identified through the Centers for Disease Control and Prevention’s 1998 and 2000 National Health Interview Surveys.

Prior research has shown that black men have a 50 percent higher incidence of prostate cancer and more than double the mortality rate of white men. This research further suggests a glaring health disparity with access to health care and economics as key factors, Dr. Weinrich says.

“Black men have the right to be informed about prostate cancer screening options,” she says. “We need additional research to study the reasons why black men with a positive family history have lower screening rates than black men in general.”

Physicians should ask men specific questions about their family history. Men should also ask their families questions about who has had cancer and at what age they were diagnosed, experts say.

“While doctors cannot conclusively diagnose hereditary prostate cancer because no prostate cancer gene has been identified, answers to those questions are critical to our genetic revolution,” says Dr. Weinrich.

Scientists are discovering more each day about the disease, she says. “People should also pay attention to the research. Thanks to genetic and scientific knowledge, we know more today about prostate cancer than we did five years ago and we will learn even more in the next five years.”

Other co-authors on the study include Dr. Georgia Dunston, Howard University; Dr. Francis Collins, National Human Genome Research Institute; Dr. James Bennett, an Atlanta urologist; and other participants of the African American Hereditary Prostate Cancer Study.

“We at the School of Nursing are pleased that the Weinrichs have such depth in this area of much-needed research,” says Dr. Lucy Marion, dean of the MCG School of Nursing. “They have a long history of research for detection of cancer among older African-American men.”

Jennifer Hilliard
jhilliardmcg.edu
706-721-8604
Medical College of Georgia

The European Association of Urology (EAU) is an association with approx. 8,000 members (European urologists) and a Central Office in The Netherlands. The EAU is the link for more than 16,000 urologists, urologists-in-training and urological scientists.

One of the EAU’s activities is the organisation of its annual congress.

The 21st Annual Congress of the EAU will be organised from 5-8 April 2006 in Paris. This is the largest urological congress in Europe and the second largest in the world. We expect well over 8,000 urologists from all over the world to attend.

What can you expect?

An international exchange of high quality scientific information is available to our visitors through scientific sessions, state-of-the-art lectures, educational courses and satellite symposia. The European School of Urology (ESU) offers courses in which all contemporary urological issues are dealt with and the European Society of Uro-Technology (ESUT) offers hands-on training sessions.

Furthermore, a technical exhibition will be held. The newest developments of the pharmaceutical and technical equipment industries are to be exhibited. Delegates of many industries and scientific publishers shall be present for information.

The press conference of the EAU will be held on Wednesday 5 April from 12 to 12.45 hours. Prof L. Boccon-Gibod, Congress President, will give an introduction to the EAU and the Congress. The EAU identified the following key topics, of which a short overview will be presented (in random order):

– Prof P. Teillac
New technologies in the treatment of prostate cancer

– Prof P.-A. Abrahamsson
New biological targets for renal cell cancer; angiogenesis inhibition, a major breakthrough in the treatment of kidney tumours

– Prof. C. Chapple
Overactive bladder in men, the latest developments

– Prof M. Wirth
The role of robotic surgery

This year’s congress venue is:
Palais des Congrиs,
2, Place de la Porte Maillot,
75017 PARIS
France

More information

For more details and the full programme we refer to the congress website:
www.eauparis2006.

Should you have any questions, please contact Mrs Lindy Brouwer, Communication Officer at communicationofficeuroweb or by phone: +31 (0)26 3890680.

Vegetables that have a naturally occurring compound called 13C improve DNA repair in cells, this in turn helps stop them becoming cancerous, say researchers at Georgetown University, Washington, USA. You can read about this study in the British Journal of Cancer.

Rosen (2006) British Journal of Cancer 94 (3)

The researchers also found that geistein, which is found in soy beans, also enhances DNA repair in cells (protecting them from becoming cancerous).

Previous studies have indicated there is a link between eating such foods and cancer protection. This study actually puts forward a molecular mechanism on why this happens.

Genes called BRCA1 and BRCA2 are repair proteins – they prevent damaged genetic information being passed on to the next generation of cells. If your BRCA genes are faulty you have a higher risk of developing cancer, especially cancer of the breast, ovary and prostate.

Cancer cells have lower levels of BRCA proteins, so higher levels should prevent the cancer from thriving. 13C and genistein increase the amount of BRCA proteins, which in turn raise your defences against cancer(s). 13C and geistein raise levels of both BRCA1 and BRCA2.

Professor Eliot Rosen, team leader, said “Studies that monitor people’s diets and their health have found links between certain types of food and cancer risk. However, before we can say a food protects against cancer, we have to understand how it does this at a molecular level. It is now clear that the function of crucial cancer genes can be influenced by compounds in the things we eat. Our findings suggest a clear molecular process that would explain the connection between diet and cancer prevention.”

The herbal remedy Saw Palmetto is
no more effective than a placebo at treating symptoms related to enlargement
of the prostate gland, according to a new study in the Feb. 9 issue of the New
England Journal of Medicine.

“The results are disappointing, particularly for the estimated 2 million
American men who take saw palmetto,” said Andy Avins, MD, MPH, of the Kaiser
Permanente Division of Research in Oakland, Calif., and co-leader of the
study.

In Benign Prostatic Hyperplasia (BPH), the prostate gland enlarges,
causing an obstruction that can impair urinary function. Saw palmetto is
commonly used as an alternative to prescription medications. The National
Institutes of Health says BPH affects more than half of men 60 and older, and
more than 90 percent of men 70 and older.

The year-long, double-blind study, by researchers at Kaiser Permanente and
UCSF/San Francisco VA Medical Center, followed 225 men diagnosed with BPH.

The patients were randomly assigned to take either 160 mg of saw palmetto (the
amount used in the vast majority of prior clinical trials) or a placebo twice
a day for one year. The researchers say there was no statistically significant
difference between the two groups in terms of symptom changes either during
the trial, or at the end of the year.

“Obviously this is not encouraging news for men who are considering taking
saw palmetto to treat their BPH,” said Avins. “Not only did it show no overall
benefit, but it also showed no benefit when we looked at it in subgroups of
patients who had different levels of severity of symptoms, or who had
different sizes of prostate.”

The study’s findings contradict several previous studies, which suggested
the herb was an effective treatment for BPH. The researchers say there are
several possible explanations for this. Previous studies were smaller in size
and duration. In measuring the severity of BPH, most of those studies did not
apply the same method that is commonly used to measure the effectiveness of
prescription medications for the problem.

Another potential problem with earlier studies has to do with the nature
of saw palmetto itself, according to Stephen Bent, MD, staff physician at the
San Francisco VA Medical Center and co-author of the study. “This is a very
pungent herb, and it took our research team a long time to create a placebo
that convincingly duplicates its strong smell and taste. We suspect that prior
trials didn’t adequately address that problem.” Bent said.

He added: “It’s possible that some of the positive findings in earlier
work may be due to the fact that the blinding wasn’t adequate. Someone who’s
taking something that’s smelly and likely to be the plant extract is perhaps
more likely to report a benefit than someone who’s taking an odorless and
tasteless tablet.” The researchers say this may not be the final word on the
subject. They say it is possible saw palmetto may be effective at higher
doses.

Co-authors of the study include: Christopher Kane, MD, and Katsuto
Shinohara, MD, of the San Francisco VA Medical Center; John Neuhaus, PhD and
Esther S. Hudes, PhD, MPH, of UCSF; and Harley Goldberg, DO, of Kaiser
Permanente Northern California and UCSF. The study was funded by a grant from
the NIH that was administered by the Northern California Institute for
Research and Education.

Kaiser Permanente has research offices in California, Oregon, Hawaii,
Georgia, Colorado, Maryland, and Ohio. Results of research conducted by Kaiser
Permanente physicians and investigators have been published in the Journal of
the American Medical Association, the New England Journal of Medicine, the
Permanente Journal, the American Journal of Public Health, Pediatrics, and
other clinical journals. Kaiser Permanente is America’s leading integrated
health plan. Founded in 1945, it is a nonprofit, group practice prepayment
program with headquarters in Oakland, Calif. Kaiser Permanente serves the
health care needs of 8.3 million members in 9 states and the District of
Columbia.

UCSF is a leading university that consistently defines health care
worldwide by conducting advanced biomedical research, educating graduate
students in the life sciences, and providing complex patient care.

kaiserpermanente