Botox May Ease Enlarged Prostate Symptoms

Another study links high testosterone levels to increased prostate cancer risk

WEDNESDAY, May 12, 2004 (HealthDayNews) -- Botox, which has already proven its worth banishing wrinkles and battling migraines, is now emerging as a possible treatment for prostate problems.

Researchers from the University of Pittsburgh Medical Center say Botox may help alleviate symptoms of an enlarged prostate -- a condition called benign prostatic hyperplasia (BPH). They presented their findings May 11 at the American Urological Association meeting in San Francisco.

At another presentation at the same meeting, researchers reported that higher levels of so-called "free" testosterone were associated with an increased risk of prostate cancer.

The University of Pittsburgh scientists injected Botox into the prostates of 11 men between the ages of 50 and 82. All had an enlarged prostate, which causes symptoms such as frequent urination, an inability to completely empty the bladder and urinary tract infections.

The men had all tried alpha-blocker treatments, and had not responded to the therapy.

Within three to seven days of the injections, the men's average score on a prostate symptom scale had decreased by 62 percent, and a quality-of-life scale score increased by 57 percent.

"We have completed a number of studies that have shown Botox injections are a safe and effective treatment for conditions of the lower urinary tract," Dr. Michael Chancellor, a professor of urology and gynecology, said in a statement. "In this study, we have shown the same may be true for using Botox injections for enlarged prostate."

In the testosterone study, researchers found higher levels were associated with an increased risk of prostate cancer.

One of the study authors, Dr. J. Kellogg Parsons, said the researchers wanted to see if higher levels of testosterone were linked to a higher incidence of prostate cancer because testosterone-replacement therapy is becoming more widespread.

"In this cohort of aging men, we did see a significant association between the serum testosterone index and prostate cancer," said Parsons, an instructor of urology at Johns Hopkins School of Medicine.

He said that men whose testosterone levels placed them in the upper 75th percentile had an 88 percent higher risk of prostate cancer than men in the 25th percentile. Men in the lowest 25th percentile, he added, had levels of free testosterone considered clinically low.

Each year, more than 230,000 men are diagnosed with prostate cancer, according to the American Cancer Society (ACS). Over a lifetime, prostate cancer strikes one of every six men, according to the ACS. Almost 30,000 American men die annually from the disease.

In its early stages, prostate cancer often has no symptoms. As it advances, it can cause impotence, blood in the urine and pelvic or hip pain.

For the testosterone study, Parsons and his colleagues tested blood samples from 794 middle-aged and older men, including 114 who had prostate cancer. The samples had been collected over a 40-year period as part of another study. The average age of diagnosis for the men with prostate cancer was 75.

Overall levels of testosterone weren't associated with an increased risk of cancer, said Parsons, but high levels of "free" testosterone were. Free testosterone, Parsons explained, is different from other forms of testosterone because it isn't bound to any proteins and can be taken up into the body's tissues, including prostate cells.

Parsons said it's important to note that this research doesn't mean testosterone causes prostate cancer.

"Our study raises the question whether increasing testosterone levels may potentially increase the risk of prostate cancer," Parsons explained.

Dr. Simon Hall, chairman of the department of urology at Mount Sinai Medical Center in New York City, said he doesn't think this study will change the way men with low testosterone levels are treated. He said for every study that shows a potential increase in risk, there seems to be another that doesn't find an increase. More important, larger studies haven't found a correlation between testosterone levels and prostate cancer, he said.

"I don't think this should alter how someone makes a decision" on testosterone therapy, said Hall. If you have low levels of testosterone, you "should be treated and monitored just the same. You should have a PSA test and a rectal exam before starting therapy, and if any abnormalities show up after starting therapy you should be reevaluated and you may have to stop hormone treatment."

More information

To learn more about prostate cancer, visit the National Cancer Institute or the American Cancer Society.

SOURCES: J. Kellogg Parsons, M.D., instructor, urology, Johns Hopkins School of Medicine, Baltimore; Simon Hall, M.D., chairman, department of urology, Mount Sinai Medical Center, New York City; May 9 and May 11, 2004, presentations, American Urological Association annual meeting, San Francisco
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