July 12, 2013

Prostate most cancers research monitors long-term urinary, lovemaking as well as intestinal perform unwanted effects

A new study comparing outcomes among prostate cancer patients treated with surgery versus radiotherapy found differences in urinary, bowel and sexual function after short-term follow-up, but those differences were no longer significant 15 years after initial treatment.

The study, led by first author Matthew Resnick, M.D., instructor in Urologic Surgery, Vanderbilt University Medical Center, was published in the Jan. 31 issue of the New England Journal of Medicine.

From Oct. 1, 1994, through Oct. 31, 1995, investigators enrolled men who had been diagnosed with localized prostate cancer in the Prostate Cancer Outcomes Study (PCOS).

For the current study, investigators followed 1,655 men between the ages of 55 and 74 from the PCOS group, of whom 1,164 (70.3 percent) had undergone prostatectomy, while 491 (29.7 percent) had undergone radiotherapy. At the time of enrollment, the patients were asked to complete a survey about clinical and demographic issues and health-related quality of life. The men were contacted again at set times following treatment and were asked about clinical outcomes and disease-specific quality of life issues.

Men whose prostates had been surgically removed were significantly more likely than those who received radiation therapy to report urinary leakage at two years and five years. However, at 15 years, the investigators found no significant difference in the adjusted odds of urinary incontinence. Nonetheless, patients in the surgery group were more likely to wear incontinence pads throughout the 15-year follow-up period.

Men in the prostatectomy group were also significantly more likely than those in the radiotherapy g.

s had to be reprinted 5 times in one month to keep pace with demand. It seemed we had tapped into not so much a gap but a Grand Canyon-sized crater in the market.1993 – 2008 Black Lace books are unashamedly explicit and have explored areas of sexual fantasy where other women's erotica has feared to tread. With many of the books exploring the experimental side of sex, they've attracted considerable attention. We have now published over 400 titles and sold over four million books. They have been translated into languages as diverse as Japanese and Czech.1993 – 2008 Female sexuality is always a hot media item and these days, more women than men are reading and writing erotica and feeling very comfortable with what has traditionally been seen as a male-only preserve.1993 – 2008 We've always favoured writing that hits the ground running, takes no prisoners and entertains as well as arouses its audience. Some titles could easily be classified as literary, others are populist – we just publish the best erotica we see that is written by women.2000 – 2006 And we've ensured that Black Lace books have changed and developed to keep pace with an increasingly sophisticated audience. In the nineties we published many stories with historical themes, but at the start of the new millennium our readership wanted upbeat contemporary stories with loads of outrageous sex – in line with cultural trends and lifestyle changes.

ts on pregnancy or breastfeeding.

Current data also suggest that Griffithsin may also be appropriate for rectal, as well as vaginal, use. Hillier announced that the MTN research portfolio contains a proposed Phase 1 trial (MTN 044) in which 45 women and men who have receptive anal sex would test its safety and acceptability for rectal use.3 No timeframe for either of these trials can be set until funding for them is confirmed.

As noted above, ARV‐based products are currently the primary focus of microbicide research and we are still several years away from knowing whether Griffithsin, or any of the non-ARV-based microbicide candidates, are effective. But it is very encouraging that MTN, one of the largest clinical trial networks working on microbicide development, is including non-ARV-based candidates in its research portfolio and preparing to move them into clinical trials. Surely, advocates pushing for accessible ARV treatment to enable women and men living with HIV to extend their lifespans also need to advocate for development of a full range of secondary prevention options to help support the sexual and reproductive health of people living with HIV.


Footnotes

1. Hillier S. Overview of Products in Development-Topical. [Presenation] Forum for Coolborative HIV Research. meeting on Future of PrEP and Microbicides, Washington DC, 7 January 2013.

2. Zeitlin L, Pauley M, Whaley KJ. Second-generation HIV microbicides: Continued development of griffithsin.PNAS 2009 106 (15) 6029-6030.

3. Hillier S. Overview of Products in Development-Topical. [Presenation] Forum for Coolborative HIV Research. meeting on Future of PrEP and Microbicides, Washington DC, 7 January 2013.

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