BACKGROUND: About half of all men over age 50 in the United States suffer from an enlarged prostate. The prostate usually begins to grow when men are in their 40s and can vary from mild symptoms to unbearably painful ones. Statistics show that one in four men over age 60 will have such extreme symptoms that he will require medical treatment for physical relief.

The enlarged prostate condition is a noncancerous growth referred to as benign prostatic hyperplasia (BPH) in the medical community. Ironically, this condition is not benign. If not cared for properly it can lead to kidney damage or failure. One way the prostate can grow is when cells multiply around the urine passageway, through the prostate and then begin to compress against it. Another way occurs when cells grow in the urine tube and eventually into the bladder. This growth is much more serious and can only be cleared through surgery.

Some of the symptoms of BPH include frequent urination, nighttime urination, difficulty starting the stream, and incomplete emptying of the bladder. Not all men with enlarged prostates need treatment. Current treatments include medications, noninvasive procedures that use heat to destroy excess tissue, or surgery.

STUDY: Researchers at the University of Texas Southwestern Medical Center at Dallas spearheaded a five-year, multicenter study involving nearly 3,000 men with BPH. The men took either doxazosin (Cardura), finasteride (Proscar), a combination of the two or a placebo. The most significant result showed patients receiving the combination therapy had a 66 percent reduced risk of overall prostate clinical progression. One of the study’s co-authors, urologist Dr. Claus G. Roehrborn, said, “Our results indicate that long-term treatment with combination therapy is both safe and the most effective therapy for patients with lower urinary tract symptoms and benign prostatic hyperplasia."

Patients undergoing the combination-drug treatment most commonly reported abnormal ejaculation. Roehrborn noted only a few men in the study experienced side effects and none were permanent or dangerous. The combination therapy is a long-term treatment that may help many men avoid surgery.

WHAT’S NEXT? Researchers hope to get the word out about their findings. Roehrborn said about 30 percent of men diagnosed with BPH are excellent candidates for combination therapy. He acknowledges that taking two pills is obviously more expensive than one, so the treatment should be used on men that doctors believe will benefit the most. In another recent study, researchers found one of the drugs -- finasteride -- is effective in preventing prostate cancer in some men.

FOR MORE INFORMATION, PLEASE CONTACT:
UT Southwestern Urology Clinic
(214) 645-8765

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