Wednesday, April 29, 2009

Drug that prevents prostate cancer may be here within a year

The evidence for any effect of the drug is quite weak. Only small differences were shown

The world's first drug to prevent prostate cancer could be on sale in as little as a year. In tests, Avodart cut cases in men at high risk of the disease by almost a quarter. Researchers described the results as exciting and said in time the drug could be widely used to stave off the cancer.

Prostate cancer is the most common cancer in British men, with almost 35,000 cases a year and 10,000 deaths. It is curable if caught early but conventional treatments, including drugs, surgery and radiotherapy, carry a risk of side-effects including loss of libido and impotence. Options for stopping the disease from developing in the first place are limited to following a healthy diet.

Researcher Gerald Andriole, of Washington University School of Medicine in the U.S., tracked the health of 8,200 men aged between 50 and 75 for four years. All were judged to be at high risk of prostate cancer. Blood tests had showed them to have high levels of PSA - a protein linked to the cancer - but biopsies had declared them to be free of the disease.

Half took Avodart and half took a dummy drug. After two years, prostate cancer was found in 17.2 per cent of men who took the placebo, compared to 13.3 per cent who took Avodart. After four years, the disease was diagnosed in another 11.8 per cent of men taking the dummy drug but just 9.1 per cent of those on the active drug.

Overall, Avodart cut the development of prostate cancer by 23 per cent. Dr Andriole said it was likely the drug had zapped tumours that started out too small to be detected by biopsy. 'I think the medication caused some of those cancers to shrink and probably caused a lot of them to grow a lot slower,' he said. The researcher said the drug could be used to keep the cancer at bay in men who, like those in the trial, had high PSA levels but negative biopsies.

Avodart is made by GlaxoSmithKline which funded the study. The drug is already approved to treat enlargement of the prostate and could be cleared to prevent cancer in as little as a year. Side-effects such as impotence and the development of 'man breasts' are relatively rare but do occur.

Experts welcomed the study but said more work was needed to show if Avodart was effective in prostate cancer prevention. Professor Jonathan Waxman, of Imperial College London, said a four-year-trial was too short to prove the real worth of the drug. He said: 'The disease is very common and to have something you could put in the water to decrease the risk of getting the disease would be very important but I'm not sure it's this drug.' He added there was clear evidence a healthy diet helped prevent the disease. Vitamin D may also be beneficial.

And statins may offer protection too. Cholesterol-busting drugs taken by millions of men to cut their risk of heart attacks and stroke may also ward off prostate cancer. A 15-year study of almost 2,500 men aged between 40 and 79 found that only 6 per cent of those taking statins were diagnosed with the disease - a third of the figure for the non-statin users. [That's because you have to be pretty healthy to tolerate statins in the first place]

Urologist Dr Rodney Breau said: 'In recent years it has been suggested statin medications may prevent development of cancer. However, until now, there has been limited evidence to support this theory.'

Researchers at the the Mayo Clinic in Minnesota also found statin users had less than half the chance of developing an enlarged prostate and the problems in passing urine associated with it. However, they told the American Urological Association's annual conference that more research was needed to prove statins were pivotal in prostate health.

Elsewhere, a study has shown that vitamin D could also provide a powerful weapon against the cancer. A daily dose cut or stabilised signs of the disease in 60 per cent of patients monitored. The effect was as dramatic as that achieved by some cancer drugs. Vitamin D however is much cheaper --costing pennies a tablet.

Researcher Professor Jonathan Waxman, of Imperial College London, stressed patients should not start taking the vitamin without first speaking to their GP and they should continue with conventional treatments.


'Bleach bath' benefit for eczema

The effect here appears to be quite strong -- as it should be. Bleach is a strong germicide

Adding bleach to the bath may be an effective treatment for chronic eczema, US researchers say. In a study of 31 children, there was significant improvement in eczema in those who had diluted bleach baths compared with normal baths. The Pediatrics study also showed improvements were only on parts of the body submerged in the bath.

UK experts stressed the treatment could be extremely dangerous and should only be done under the care of a specialist.

Children with bad eczema suffer from chronic skin infections, most commonly caused by Staphylococcus aureus, which worsen the eczema that can be difficult to treat. Some children get resistant MRSA infections. Studies have shown a direct correlation between the number of bacteria on the skin and the severity of the eczema. It has been shown that bacteria cause inflammation and further weaken the skin barrier.

In the study, researchers randomly assigned patients who had infection with Staphylococcus aureus to baths with half a cup of sodium hypochlorite per full tub or normal water baths for five to 10 minutes twice a week for three months. They also prescribed a topical antibiotic ointment or dummy ointment for them to put into their nose - a key site for growth of the bacteria.

Eczema severity in patients reduced five times as much as those on placebo. But there was no improvement in eczema on the head and neck - areas not submerged in the bath.

"We've long struggled with staphylococcal infections in patients with eczema," said study leader Dr Amy Paller, from Northwestern University in Chicago. She added they saw such rapid improvement in the children having bleach baths that they stopped the study early. "The eczema kept getting better and better with the bleach baths and these baths prevented it from flaring again, which is an ongoing problem for these kids. "We presume the bleach has antibacterial properties and decreased the number of bacteria on the skin, which is one of the drivers of flares."

Professor Mike Cork, head of dermatology research and a consultant at Sheffield Children's Hospital, said antiseptic baths had been used as a treatment for eczema for quite a while but the trial was important because it highlights the benefits from reducing bacteria. "But people should not start putting bleach in their children's bath. "Bleach used incorrectly could cause enormous harm to a child with atopic eczema while, in the hands of an expert, it can as this trial indicates lead to benefit."

He added the trial highlighted the need for children with uncontrolled eczema to be referred to a specialist for treatment.


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