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The following reflects new findings and outcomes in medical research as presented at major medical meetings and published peer-reviewed medical journals. In this section members can view reports from important congresses as well as summaries of some recently published journal articles. Please let us know if you have a particular area of interest you would like to see covered. PRIORITY PRESS - 26th International Papillomavirus Conference and Clinical and Public Health Workshops Enhanced Treatment Strategies for External Genital WartsMontreal, Quebec / July 3-8, 2010 Montreal - External genital warts (GWs) are the most common sexual health disorder for which young men and women seek medical attention and, globally, more cases and recurrent episodes are being reported. GWs are associated with considerable psychological distress and potentially very unpleasant and painful treatment. Although the natural history of GWs suggests that most patients will eventually clear the warts, treatment with an immune response modifier may accelerate the natural immune (...) Read more... PRIORITY PRESS - 105th Annual Meeting of the American Urological Association GnRH Antagonists: Advances in Androgen Deprivation Therapy for Prostate CancerSan Francisco, California / May 29-June 3, 2010 San Francisco - GnRH agonists effectively suppress testosterone in over 90% of patients with advanced prostate cancer but can require as much as 30 days to achieve full suppressive effects, during which time testosterone levels actually increase. In contrast, GnRH antagonists are a class of compounds that achieve immediate receptor blockade, thus avoiding testosterone surge. Data from the pivotal phase III trial of the new-generation GnRH antagonist degarelix showed that after 12 months of (...) Read more... PRIORITY PRESS - 25th Congress of the European Association of Urology Androgen Deprivation Therapy in Prostate CancerBarcelona, Spain / April 16-20, 2010 Barcelona - New data have reinforced the utility of a gonadotropin-releasing hormone (GnRH) receptor blocker for slowing progression of advanced prostate cancer. Following a previous phase III study in which this agent compared favourably to a GnRH agonist as first-line therapy, a new multicentre study has demonstrated that this same GnRH receptor blocker is also highly effective as a second-line therapy. In the study, 88% of patients achieved undetectable luteinizing hormone (LH) levels (...) Read more... PRIORITY PRESS - 3rd World Congress on Controversies in Urology An Enhanced Medical Approach to Androgen Suppression in Prostate CancerAthens, Greece / February 25-28, 2010 Athens - It has been 70 years since investigators first understood that prostate cancer is hormone-sensitive and that medical suppression of testosterone production can control the tumour and affect long-term disease outcomes. Yet there are still questions concerning the best form of androgen-deprivation therapy as well as the specific patient groups who will gain the most benefit from treatment. Gonadotropin-releasing hormone (GnRH) agonists have been extensively used for treatment of (...) Read more... PRIORITY PRESS - EUROGIN 2010 9th International Multidisciplinary Congress Vaccination Against HPV Reduces Burden of Disease in Its Earliest ManifestationsMonte Carlo, Monaco / February 17-20, 2010 Monte Carlo - Many theoretical arguments have been raised in support of vaccination against human papillomavirus (HPV). Now, for the first time, compelling evidence that vaccination does reduce the earliest manifestations of infection in the form of genital warts was reported here this week. End-of-study results continue to support the efficacy of the quadrivalent vaccine against high-grade cervical lesions in older women, which has important implications for the prevention of cervical (...) Read more... PRIORITY PRESS - Society of Urologic Surgeons of Ontario Meeting Improving Survival in Prostate Cancer Through Enhanced Androgen SuppressionToronto, Ontario / October 21, 2009 Toronto - Therapeutic options for the treatment of prostate cancer continue to expand, from orchiectomy, the first effective treatment, through to a variety of formulations of gonadotropin-releasing hormone (GnRH) agonists and now, more recently, a GnRH antagonist. The GnRH agonists lower testosterone effectively but not immediately and testosterone is prone to surge on initiation of treatment and on subsequent injections. In contrast, the GnRH antagonist is not associated with testosterone (...) Read more... MEDICAL FRONTIERS - 64th Annual Meeting of the Canadian Urological Association Prostate Cancer Risk Reduction with 5-alpha Reductase InhibitorsToronto, Ontario / June 28-July 1, 2009 Toronto - Research efforts continue to examine the possible role of risk reduction initiatives in prostate cancer and there have been several important new developments in the field. For example, recent analyses of the initial PCPT (Prostate Cancer Prevention Trial) results reaffirmed the reduction in rate of prostate cancer diagnosis with the selective type 2 5-alpha reductase inhibitor (5-ARI) finasteride compared to placebo and results of a second large trial of another 5-ARI, (...) Read more... PRIORITY PRESS - Primary Care Today Outgrowing Old Attitudes and Approaches to Nocturnal EnuresisToronto, Ontario / May 7-9, 2009 Toronto - Nocturnal enuresis is the frequent involuntary discharge of urine during sleep in children who have reached an age at which bladder control is expected. It is a condition that frustrates parents and can engender low self-esteem and restriction of activities in children. It is often dismissed as trivial but is a medical condition related to slow maturation of various processes involving both bladder control and sleep. Effective treatment can reduce bedwetting and its psychological (...) Read more... PRIORITY PRESS - 104th Annual Meeting of the American Urological Society Relearning and Refining the Lessons from the Prostate Cancer Prevention TrialChicago, Illinois / April 25-30, 2009 Chicago - Few clinical trials have met with such diverse reactions as those that followed the findings of the PCPT (Prostate Cancer Prevention Trial). The trial represented an unprecedented triumph in cancer prevention, demonstrating a 25% reduction in the incidence of prostate cancer among healthy men who received the 5-alpha reductase inhibitor (5-ARI) finasteride for seven years. However, a small, but statistically significant increase in the incidence of high-grade prostate cancers (...) Read more... PRIORITY PRESS - 104th Annual Meeting of the American Urological Association Androgen Deprivation Therapy for Prostate Cancer: From Hormonal Agonism to AntagonismChicago, Illinois / April 25-30, 2009 Chicago - Androgen deprivation therapy (ADT) has become an integral component of treatment for many patients with hormone-sensitive advanced prostate cancer. Multiple studies have shown that ADT blunts the progression of prostate cancer, and several investigations have provided evidence of improved survival. However, the evidence has not been uniformly consistent. One recent study showed an increased mortality hazard among older men with advanced prostate cancer treated with ADT. Laboratory (...) Read more... PRIORITY PRESS - 104th Annual Meeting of the American Urological Association New Approaches to the Management of Male LUTSChicago, Illinois / April 25-30, 2009 Chicago - Overactive bladder (OAB) has historically been underrecognized in men as a contributor to lower urinary tract symptoms, with most symptoms being attributed primarily to benign prostatic hyperplasia. A new survey shows the prevalence of OAB symptoms in men to be about 25%, which rises with increasing age. However, fewer than one-third of men sought treatment for their symptoms. In men with larger prostates and persistent OAB symptoms despite treatment with an 5-alpha-reductase (...) Read more... PRIORITY PRESS - 104th Annual Meeting of the American Urological Association The Challenge of Urgency: Recent Advances in Recognizing and Treating Overactive BladderChicago, Illinois / April 25-30, 2009 Chicago - Overactive bladder (OAB) comprises a constellation of lower urinary tract symptoms that include frequency and urgency, with or without urinary incontinence. An estimated 12% to 18% of Canadians have OAB, and that figure may underestimate the true prevalence, as the condition is thought to be underreported and undertreated. Traditionally, anticholinergic or antimuscarinic compounds have formed the basis of pharmacologic therapy for OAB. These agents target abnormal detrusor muscle (...) Read more... PRIORITY PRESS - 24th Annual Congress of the European Association of Urology Managing Severely Symptomatic Benign Prostatic Hyperplasia: More from CombATStockholm, Sweden / March 17-21, 2009 Stockholm - One consequence of the dramatic growth in the world’s elderly population today is a potentially daunting increase in the number of men who will require treatment for lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). This year’s EAU congress was told that over a quarter of all men in their 60s and a third of those in their 70s are already possible candidates for BPH treatment, and millions more will be at risk in the future. Is current practice, with (...) Read more... MEDI-NEWS Based on 2009 ASCO/AUA Guideline Prostate Cancer Prevention with 5-alpha Reductase Inhibitors: Clinical Guideline and RecommendationsMarch 2009 For many types of cancer, prevention remains a challenge because of an incomplete understanding of potentially modifiable risk factors. With respect to prostate cancer, an opportunity for chemoprevention arose from the recognition that dihydrotestosterone (DHT) drives the development and progression of the disease. The opportunity came in the form of finasteride, an inhibitor of 5-alpha reductase, the enzyme required to convert testosterone into DHT. The landmark PCPT (Prostate Cancer (...) Read more... 9th Annual Society of Urologic Oncology Winter Meeting Advances in Androgen-deprivation Therapy for Prostate CancerBethesda, Maryland / December 4-6, 2008 Bethesda - In advanced prostate cancer, androgen-deprivation therapy (ADT) is achieved through bilateral orchidectomy or by administration of gonadotropin-releasing hormone (GnRH) agonists. While the latter may be a preferred option for many patients, the desired effects take time and testosterone surges may occur that can stimulate the hormone-dependent tumours. A new class of agents, the GnRH antagonists, produces rapid androgen suppression without the testosterone surge. However, (...) Read more... 38th Annual Meeting of the International Continence Society Issues in Overactive Bladder Therapy: Targeting the Urgency DriverCairo, Egypt / October 20-24, 2008 Cairo - Overactive bladder (OAB) affects at least a sixth of all Canadians, yet it remains under-recognized and under-treated. Often, patients assume that OAB is an unavoidable effect of aging. While efficacy of antimuscarinics has been demonstrated to relieve OAB symptoms, issues regarding efficacy in patients with severe OAB or the potential to safely combine treatments in patients developing OAB consequent to lower urinary tracts symptoms were examined in new studies with the (...) Read more... 63rd Annual Meeting of the Canadian Urological Association Prostate Volume and PSA: Predictors of Disease Progression and Treatment Response in LUTS and BPHEdmonton, Alberta / June 22-25, 2008 Edmonton - The proportion of men with lower urinary tract symptoms and benign prostatic hyperplasia is substantial and growing. Predicting which men will progress is important as it helps optimize treatment selection. Prostate volume and prostatic-specific antigen are linked and should be integrated into the decision algorithm so as to select the most effective treatment strategy for optimal symptom relief. Preliminary evidence also suggests that 5-alpha reductase inhibitors may attenuate (...) Read more... 63rd Annual Meeting of the Canadian Urological Association 5-alpha Reductase Inhibitors in Prostate Cancer Prevention: The PCPT RevisitedEdmonton, Alberta / June 22-25, 2008 Edmonton - The PCPT (Prostate Cancer Prevention Trial) was a large independent randomized trial designed to answer whether long-term treatment with the 5-alpha reductase inhibitor (5ARI) finasteride could prevent prostate cancer in men ³55 years of age with an entry prostate-specific antigen level of 3 ng/mL. Seven years later, that answer was an unequivocal yes. Yet uptake of the 5ARI for prostate cancer prevention has been modest due to what was perceived to be a small increase in (...) Read more... 103rd Annual Meeting of the American Urological Association Paradigm Shift in the Primary Prevention of Prostate Cancer: Reanalysis of the PCPT DataOrlando, Florida / May 17-22, 2008 Orlando - Approximately 200,000 men are diagnosed with prostate cancer in the US annually and over 90% of them receive treatment for it. Reducing the frequency of diagnosed cancer could spare a substantial proportion the consequences of such a diagnosis, including treatment that can be associated with considerable morbidity. New analyses from the Prostate Cancer Prevention Trial clearly demonstrate that the 5-alpha reductase inhibitor (5ARI) finasteride is not associated with an excess (...) Read more... 103rd Annual Meeting of the American Urological Association Managing the Three Major Facets of Benign Prostatic HyperplasiaOrlando, Florida / May 17-22, 2008 Orlando - The MTOPS study demonstrated that combination therapy significantly decreased the four-year incidence of disease progression in men with benign prostatic hyperplasia (BPH) compared with an a-blocker, a 5a-reductase inhibitor (5ARI) or placebo alone, but only a subset of men in MTOPS were at heightened risk for progression due to a prostate volume of ³30 cc or prostate-specific antigen (PSA) levels of ³1.5 ng/mL. The dual 5ARI dutasteride results in a greater degree of (...) Read more... |