UPDATE - Issue 29 - Spring 2007
New test for severe BPH
Millions of middle-aged and older men experience the symptoms of an enlarged prostate multiple times during the day and night. It now appears that the disease known as Benign Prostatic Hyperplasia (BPH) and marked by urgency and frequent urination, is not one but two disorders, and that one of the pair - tied to a newly identified gene - has far more serious implications.
Researchers at Johns Hopkins Hospital, New York reported in February's Journal of Urology, finding (in a study of 85 men) substantially higher levels of a protein made by a gene known as JM-27 in men whose BPH is more severe and more likely to lead to bladder-related complications if left untreated. The team also developed a blood test that detects the JM-27 protein in men with severe symptoms.
BPH - two diseases?
The experiments show that the expression of this marker is related to the presence of the severe form of BPH and not to the size of the prostate or to the presence or risk of prostate cancer. It appears that BPH is, in fact, two diseases: one form that produces more mild symptoms and is less likely to lead to bladder and other urinary tract damage, and another that is highly symptomatic with increased potential to do damage to the bladder.
The new and, as yet, unapproved biomarker test identifies approximately 90% of the men with the severe form of BPH and only incorrectly classifies men as having this form of the disease in 23% of the cases.
BPH is extremely common with an incidence roughly equal to the age of the men. 50% of men in their 50s have the disease, and this increases to 80% for those in their 80s. Current medical therapy for men who suffer from BPH uses two classes of drugs: alpha-blockers, which relax the prostate and 5-alpha reductase inhibitors, which help to shrink it. Forms of BPH that do not respond to medical therapies frequently require surgical intervention. Should this test become established, it would be most welcome.