Do you have BPH? If you’re a man, chances are, you will. Your risk of BPH (benign prostatic hyperplasia) increases every year after age 40. It’s present in 20 percent of men in their fifties, 60 percent of men in their sixties, and 70 percent of men by age 70. For some men, BPH is not so bad; for others — more than 350,000 a year in the United States alone — the symptoms of urinary obstruction or irritation eventually require treatment; if treatment is delayed, or the symptoms are very severe, the bladder may be damaged.

Scientists used to think all BPH was
created equal. Not anymore. On the
genetic level, severe BPH is dramatically
different from milder forms.

“Not all BPH is created equal,” says Robert H. Getzenberg, Ph.D., the Brady’s Research Director, and the Donald S. Coffey Professor of Urology. Although doctors and scientists have long noted the wide variation in men’s symptoms, “we considered that all types of BPH were biologically the same thing — a single disease. Now we know that this is not the case.” Getzenberg and colleagues have discovered that men with severe BPH, which can be debilitating, have dramatically different genetic findings from men with few symptoms. Their work has led them to identify a new marker, called JM-27, which is linked to the most aggressive form of BPH.

They first spotted the marker in prostate tissue samples, but recently, in research published in the February 2007 Journal of Urology, they found that JM-27 can also be detected in the blood. “This is great news, with the potential to help many men,” says Alan W. Partin, M.D., Ph.D., Director of the Brady, who envisions that one day, men may be screened for BPH just as they are now screened for prostate cancer. “If we can catch this highly symptomatic form of BPH earlier, we can treat these men, and potentially prevent some of the bladder changes that are often difficult to reverse.” Today, however, this test is still under investigation, and is not yet available for use in patients.

Interestingly, Getzenberg has found, JM-27 levels don’t seem to be affected by the presence of prostate cancer. “Also, this marker has the potential to serve as a molecular monitor — to show whether medications being given for the treatment of BPH are actually helping.” He reports that a large study is being conducted to learn more about JM-27’s effectiveness, as part of the National Institutes of Health MTOPS (Medical Therapy of Prostatic Symptoms) trial, a multi-institutional study that showed that a combination of Proscar and Cardura is more effective than either drug alone in preventing the complications of BPH.