| Two men have “ideal” prostate cancer
scenarios: Both are fairly young, in their late fifties, both have cancer
that’s detected early, when it is well within the prostate, and
both undergo radical prostatectomy. And yet —one man recovers potency
within six months; the other takes more than a year. Why?
Nobody knows for sure. The nerves that are responsible for erection have
three strikes against them with any form of treatment for prostate cancer:
They’re tiny, very frail, and unless the surgery to preserve them,
while removing the cancer, is performed flawlessly, they’re right
in the line of fire — they run in microscopic bundles along both
sides of the prostate.
In pioneering laboratory research several years ago, Arthur L. Burnett
II, M.D., professor of urology, discovered that solutions using special
proteins called immunophilinligands helped rats with nerve injury and
erectile dysfunction (similar to that found in men after radical prostatectomy)
recover penile nerve function. The immunophilinligands, and eventually,
a prototype drugcalled GPI1485, seemed to soothe, protect, invigorate
these nerves — and even to help them repair themselves — resulting
in stronger erections, recovered earlier, and dramatically less nerve
damage. The results were so promising that GPI1485 was tested
| One man recovers potency
within six months; the other takes more than a year. Why? |
in clinical trials, given orally to men undergoing radical prostatectomy
who had both nerve bundles spared.
The latest Hopkins-led trial, involving 196 men in 23 hospitals, is nearing
completion, says Burnett. “This is a Phase II investigation. Our
overall objective is to determine whether the drugs can speed up and improve
the process — whether erectile function recovery is achieved faster
and better with treatment than with nerve preservation alone.” Men
in the study are monitored up to a year, not only for erectile function,
but for health-related quality of life issues, and to make certain that
the drug is safe. “Our early impressions are that the treatment
has been well tolerated, without major side effects,” says Burnett.
“We will determine how successful this has been, and report on it
by early 2006.”
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