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A new test for prostate cancer has been approved for use in the UK which could ultimately replace the current method of diagnosing this type of cancer.  The new test measures a genetic chemical which transfers DNA coding from the PCA3 gene.  Elevated levels of this chemical indicates that prostate cancer is present. The test is called the Progensa PCA3.

The current test for prostate cancer is called the Prostate Specific Antigen (PSA) test.  The PSA test looks for a protein that leaks from the prostate gland when cancer is present but the results can be inaccurate which causes a lot of stress for the patient while he awaits the results of the biopsy which has to be performed to confirm whether or not cancer is actually present.  Certain medications, such as Propecia, can mask the real levels of PSA so your doctor should be aware of any medications that you are taking so that the results of a PSA test can be read within context.

Around 35,000 men a year are diagnosed with prostate cancer so anything that can make the detection easier and the tests more reliable must be a good thing.  The new test costs around £200 compared with £10 for a PSA test so it is unlikely that the NHS will be providing this test on a generalised basis immediately but patients should be aware of it and might be able to request it where prostate cancer is suspected by the GP.

It is 10 years since Viagra was first prescribed to treat erectile dysfunction in the UK and despite the active ingredient (sildenafil) almost never making it as a medicine, it is now turning out to be a bit of a wonder drug with potential new applications being investigated on a continual basis.

Sildenafil was originally developed as a potential treatment for angina but initial trial results were very disappointing.  The drug seemed to have little impact on the condition and there were more effective competitors on the market.  During one of the patient trials, a doctor discovered that along with other side effects such as indigestion and back pain, this new drug allowed previously impotent men to achieve erections!  This was a potentially very exciting breakthrough so it was immediately reported to Pfizer – the drug’s patent holder.  Five years later the drug was approved, not for treating angina but for erectile dysfunction.

Since the launch in 1997, Viagra has been used by an estimated 30 million men worldwide and despite the emergence of competing products, it remains the top choice for men with ED who use the services of The Online Clinic.

Viagra is now being tested for the following applications: relief of jet lag symptoms; treating stroke victims in the immediate recovery phase; helping underweight babies develop in the womb; and treatment of heart failure patients.  We intend to bring you news of these trials as soon as we have some more information, so please come back in the next few weeks to see if there have been any developments.

A study in China involving 7,684 men has concluded that smoking can be a major contributory factor to erectile dysfunction.  This is something that we have long suspected but this authoritative piece of research to be published in the American Journal of Epidemiology demonstrated that the statistical link is significant.

There appeared to be a direct correlation between the quantity of cigarettes smoked and the incidence or severity of the erectile problems.  There also appeared to be a stronger association in participants who also had diabetes.  The study included men aged 35-75 who did not have any vascular disease.

Help is at hand here if you want to give up smoking.  We are prepared to prescribe Champix for smoking cessation and there are a number of treatments for erectile dysfunction, including Viagra , that we are also prepared to prescribe.  As always, whether we will prescribe something will depend on your medical circumstances so you must complete a consultation form before we can make a decision.

A study conducted by the Southwest Oncology Group which surveyed more than 17,000 men over 55 years of age with a seven year follow-up period, has concluded that long term use of finasteride is unlikely to cause sexual dysfunction for most men who decide to take the treatment.  The study focussed on Proscar, which is the 5 mg daily dose used to treat Benign Prostatic Hyperplasia rather than the 1 mg a day dose called Propecia which is used to treat hair loss in men. It seems logical however that if no discernable problems could be detected in the long term with the 5 mg dose, then it is unlikely that the 1 mg daily dose would cause a problem in the long term either.

The study grew out of the Prostate Cancer Prevention Trial which was set up to determine whether finasteride could actually prevent prostate cancer.  The trial concluded that finasteride could reduce a man’s chances of getting prostate cancer by almost 25%.  It should be emphasised however that finasteride is not licensed for this preventative purpose.

Earlier studies into the effects of finasteride were very short term and did not take into account other factors such as age, medical condition or smoking status.  Given the other factors, it was concluded that the small average decrease in sexual function was not an important difference and that much larger differences were simply due to individual variations.

Back in January we brought you news of an exciting new drug in development which can be used to treat erectile dysfunction in men and hypoactive sexual desire disorder in women.  We now have information that the Phase IIb trials for use in men were a success and a meeting has been arranged with the FDA in August to discuss the results and to run through the requirements for the Phase III trials.  Bremelanotide tackles erectile dysfunction in a completely different way from the current generation of drugs such as Viagra.  Bremelanotide targets the central nervous system and is the first medication in a class known as melanocortin agonists.  Because of the way that this new medicine works, it is unlikely to be contraindicated for patients with heart problems or who use nitrates.  Although it will be a while before this medication is available to prescribe, initial findings do appear positive.

A revolution in the way that sexual dysfunction is treated could be just around the corner. Bremelanotide (formerly known as PT-141), which forms part of a new class of drugs called melanocortin agonists, is being developed in the United States by Palatin Technolgies. The drug works through a mechanism of actions involving the central nervous system rather than directly on the vascular system like currently available drugs, such as Viagra and Cialis. Given that Bremelanotide works in a completely different way from existing drugs on the market, it is thought that it may be able to be used by patients for whom the current generation of drugs are either contraindicated or are ineffective.

According to market data, around 40% of men who are prescribed the currently available drugs to treat erectile dysfunction do not refill their prescription as a result of a lack of efficacy or intolerable side effects. Palatin therefore believes that there is significant market demand for an alternative form of drug therapy.

Bremelanotide has been shown in four Phase 2 clinical trials to be effective in treating erectile dysfunction and it is currently undergoing Phase 2A clinical trials to treat pre-menopausal women suffering from sexual dysfunction, early results of which are encouraging according to Palatin. The drug is administered by way of a nasal spray and seems to have few side effects which are not dose related.

We will bring you more news on this exciting drug as soon as we have it.