Various treatment options for benign prostatic hyperplasia: A current update
TL;DR: Medications with combination therapies are still needs more investigation to establish as preference in initial stage for fast symptom relief reduced prostate growth and obviously reduce need for BPH-related surgery.
Abstract: In benign prostatic hyperplasia (BPH) there will be a sudden impact on overall quality of life of patient. This disease occurs normally at the age of 40 or above and also is associated with sexual dysfunction. Thus, there is a need of update on current medications of this disease. The presented review provides information on medications available for BPH. Phytotherapies with some improvements in BPH are also included. Relevant articles were identified through a search of the English-language literature indexed on MEDLINE, PUBMED, Sciencedirect and the proceedings of scientific meetings. The search terms were BPH, medications for BPH, drugs for BPH, combination therapies for BPH, Phytotherapies for BPH, Ayurveda and BPH, BPH treatments in Ayurveda. Medications including watchful waitings, Alpha one adrenoreceptor blockers, 5-alpha reductase inhibitors, combination therapies including tamsulosin-dutasteride, doxazosin-finasteride, terazosin-finasteride, tolterodine-tamsulosin and rofecoxib-finasteride were found. Herbal remedies such as Cernilton, Saxifraga stolonifera, Zi-Shen Pill (ZSP), Orbignya speciosa, Phellodendron amurense, Ganoderma lucidum, Serenoa Repens, pumpkin extract and Lepidium meyenii (Red Maca) have some improvements on BPH are included. Other than these discussions on Ayurvedic medications, TURP and minimally invasive therapies (MITs) are also included. Recent advancements in terms of newly synthesized molecules are also discussed. Specific alpha one adrenoreceptor blockers such as tamsulosin and alfuzosin will remain preferred choice of urologists for symptom relief. Medications with combination therapies are still needs more investigation to establish as preference in initial stage for fast symptom relief reduced prostate growth and obviously reduce need for BPH-related surgery. Due to lack of proper evidence Phytotherapies are not gaining much advantage. MITs and TURP are expensive and are rarely supported by healthcare systems.
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TL;DR: Results of studies about the effects of maca on sexual function, spermatogenesis, female reproductive function, memory, depression and anxiety, and energy as well as effects on benign prostatic hyperplasia, osteoporosis and metabolic syndrome are summarized.
Abstract: La maca (Lepidium meyenii) es una planta que crece sobre los 4000 metros de altitud en los Andes Centrales del Peru, presenta diferentes variedades de acuerdo al color de su hipocotilo. La presente revision resume los resultados de estudios sobre los efectos de la maca en la funcion sexual, la espermatogenesis, la funcion reproductiva femenina, la memoria, la depresion y la ansiedad, como energizante y contra la hiperplasia benigna de prostata, osteoporosis y sindrome metabolico. Se discute tambien su efecto antienvejecimiento y la seguridad en su consumo. Se han demostrado diferencias en el efecto de las variedades negra, amarilla y roja de maca. La maca negra es la que mejores resultados presenta sobre la espermatogenesis, la memoria y contra la fatiga, mientras que la maca roja es la variedad que mejor revierte la hiperplasia benigna de prostata y la osteoporosis inducida experimentalmente. Ademas, la maca reduce los niveles de glucosa, y su consumo se relaciona con la reduccion de la presion arterial y un mejor puntaje de salud. Estudios experimentales han demostrado que el consumo a corto como a largo plazo no muestra toxicidad tanto in vivo como in vitro. A pesar que los estudios experimentales han demostrado que la maca presenta diversos efectos beneficos, son necesarios mas estudios clinicos para confirmar estos resultados
48 citations
Cites background from "Various treatment options for benig..."
...Entre ellas, se describe a la maca roja (67)....
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...tores adrenérgicos alfa 1, inhibidores de la 5 alfa reductasa como el finasteride, y la combinación de terapias que incluyen tamsulosina-dutasteride, doxazosina-finasteride, terazosina-finasteride, tolterodina-tamsulosina y rofecoxib-finasteride forman parte de la estrategia terapéutica de elección para la HBP, en los últimos años está apareciendo información sobre el uso de fitoterapia para esta enfermedad (67)....
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TL;DR: It is demonstrated that ultra high performance liquid chromatography combined with quadrupole time-of-flight mass spectrometry coupled to MassLynx software and multivariate data processing approach could be successfully applied for rapid screening and comprehensive analysis of chemical constituents in vitro and prototype components or metabolites in vivo of traditional Chinese medicine.
Abstract: Zi Shen Wan is a typical formula consisting of three herbs, Phellodendri Amurensis Cortex, Rhizoma Anemarrhenae, and Cortex Cinnamomi, and has been widely used for treating prostatitis and infection diseases. However, it lacks in-depth research of the constituents of Zi Shen Wan in vivo and in vitro. In this work, ultra high performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry and MassLynx software was established to characterize the chemical compositions of Zi Shen Wan in vivo and in vitro. In total, 92 peaks were characterized in vitro and 33 peaks were characterized in vivo based on mass spectrometry and tandem mass spectrometry data. Among the 33 compounds characterized in rat plasma, 22 prototype components absorbed in rat serum and 11 metabolites were identified in vivo. This work was fully reports the chemical constituents of traditional Chinese formula of Zi Shen Wan, it demonstrated that ultra high performance liquid chromatography combined with quadrupole time-of-flight mass spectrometry coupled to MassLynx software and multivariate data processing approach could be successfully applied for rapid screening and comprehensive analysis of chemical constituents in vitro and prototype components or metabolites in vivo of traditional Chinese medicine.
36 citations
TL;DR: This is the first report suggesting selective anti-proliferative and anti-metastatic attributes of LJP extract against prostatic diseases, including PCa.
32 citations
TL;DR: The research work to understand the relationship between different beneficial foods and human health system and to explore the role of the functional foods against various diseases will be an important aspect scientifically, clinically as well as socio-economically.
Abstract: This paper reviews the potential of functional foods in our daily life. A functional food with new ingredients gives an additional function to human health. Above their basic nutritional value functional foods deliver enhanced benefits. The functional food industry is growing rapidly in recent years. Epidemiological studies as well as in vivo, in vitro, and clinical data showed that plant-based functional foods are able to reduce the risk of different chronic disease, such as cancer. These biologically active plant chemicals are known as ‘phytochemicals’. Not only phytochemicals, also there are other animal products considered as functional foods for their potential role in human health. Foods containing probiotics, prebiotics, or plant sterols are also considered as functional foods. The aim of this review was to focus on the role of functional foods on human health. The research work to understand the relationship between different beneficial foods and human health system and to explore the role of the functional foods against various diseases will be an important aspect scientifically, clinically as well as socio-economically. Finally, functional foods will be successful depending on several factors including their effectiveness, safety, and quality.
28 citations
Cites background from "Various treatment options for benig..."
...Various ethnopharmacological studies demonstrated that Cucurbita pepo is used as antiviral, analgesic urinary disorders, antimicrobial, anti-ulcer, antidiabetic, anti-cancer, and antioxidant in various diseases [212,223-230]....
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TL;DR: In silico target fishing identified maca’s traditional effects on treatment and prevention of osteoporosis, prostate cancer, and kidney diseases, and its potential function of treating cardiovascular diseases, as the most important of this herb's possible activities.
Abstract: Lepidium meyenii Walpers (maca) is an herb known as a traditional nutritional supplement and widely used in Peru, North America, and Europe to enhance human fertility and treat osteoporosis. The secondary metabolites of maca, namely, maca alkaloids, macaenes, and macamides, are bioactive compounds, but their targets are undefined. The pharmacophore-based PharmaDB targets database screening joint the ligand shape similarity-based WEGA validation approach is proposed to predict the targets of these unique constituents and was performed using Discovery Studio 4.5 and PharmaDB. A compounds–targets–diseases network was established using Cytoscape 3.2. These suitable targets and their genes were calculated and analyzed using ingenuity pathway analysis and GeneMANIA. Certain targets were identified in osteoporosis (8 targets), prostate cancer (9 targets), and kidney diseases (11 targets). This was the first study to identify the targets of these bioactive compounds in maca for cardiovascular diseases (29 targets). The compound with the most targets (46) was an amide alkaloid (MA-24). In silico target fishing identified maca’s traditional effects on treatment and prevention of osteoporosis, prostate cancer, and kidney diseases, and its potential function of treating cardiovascular diseases, as the most important of this herb’s possible activities.
21 citations
Cites background from "Various treatment options for benig..."
...There is increasing evidence that the genus Lepidium could reduce the risk of prostate cancer development [49, 50]....
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References
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TL;DR: The Surveillance Research Program of the American Cancer Society's Department of Epidemiology and Surveillance Research reports its annual compilation of estimated cancer incidence, mortality, and survival data for the United States in the year 2000.
Abstract: The Surveillance Research Program of the American Cancer Society's Department of Epidemiology and Surveillance Research reports its annual compilation of estimated cancer incidence, mortality, and survival data for the United States in the year 2000. After 70 years of increases, the recorded number of total cancer deaths among men in the US declined for the first time from 1996 to 1997. This decrease in overall male mortality is the result of recent down-turns in lung and bronchus cancer deaths, prostate cancer deaths, and colon and rectum cancer deaths. Despite decreasing numbers of deaths from female breast cancer and colon and rectum cancer, mortality associated with lung and bronchus cancer among women continues to increase. Lung cancer is expected to account for 25% of all female cancer deaths in 2000. This report also includes a summary of global cancer mortality rates using data from the World Health Organization.
3,858 citations
TL;DR: Treatment with le uprolide and flutamide is superior to treatment with leuprolide alone in patients with advanced prostate cancer, and Symptomatic improvement was greatest during the first 12 weeks of the combined androgen blockade.
Abstract: To test the hypothesis that maximal androgen blockade improves the effectiveness of the treatment of prostatic cancer, we conducted a randomized, double-blind trial in patients with disseminated, previously untreated prostate cancer (stage D2). All 603 men received leuprolide, an analogue of gonadotropin-releasing hormone that inhibits the release of gonadotropins, in combination with either placebo or flutamide, a nonsteroidal antiandrogen that inhibits the binding of androgens to the cell nucleus. As compared with the 300 patients receiving leuprolide and placebo, the 303 patients randomly assigned to receive leuprolide and flutamide had a longer progression-free survival (16.5 vs. 13.9 months; P = 0.039) and an increase in the median length of survival (35.6 vs. 28.3 months; P = 0.035). The differences between the treatments were particularly evident for men with minimal disease and good performance status; however, further studies should be conducted in this subgroup. Symptomatic improvement was greatest during the first 12 weeks of the combined androgen blockade, when leuprolide alone often produces a painful flare in the disease. We conclude that in patients with advanced prostate cancer, treatment with leuprolide and flutamide is superior to treatment with leuprolide alone.
1,433 citations
TL;DR: Screening based on PSA identifies some men with prostate cancer who have a significantly increased proportion of organ-confined tumors compared with those detected through evaluation for an abnormal digital rectal examination alone.
Abstract: Objective. —To determine whether prostate-specific antigen (PSA)—based screening alters the proportion of organ-confined prostate cancers detected. Design. —A prospective, nonrandomized, serial PSA-based screening trial (follow-up from 6 to 37 months), and a concurrent comparison group. Setting. —Genera community outpatient screening program based at a university center. Patients. —The study group consisted of 10251 men aged 50 years and older (mean and median age, 63 years; mean and median age of patients who underwent biopsies, 66 years) who presented to a prostate cancer screening program and consented to phlebotomy. The comparison group consisted of 266 concurrently studied private patients in the same age range (mean and median age, 68 years) who were referred for prostatic ultrasonography and biopsy because of an abnormal digital rectal examination (DRE). Main Outcome Measure. —Proportion detected with clinically or pathologically advanced prostate cancer. Results. —The men were divided into three groups: the comparison group, the initial PSA-based screening group, and the serial PSA-based screening group. The proportions of prostate cancers detected that were clinically or pathologically advanced were as follows: comparison group, 57% (27/47); initial PSA-based screening group, 37% (91/244); and serial PSA-based screening group, 29% (37/ 129). Screened patients had a lower proportion of advanced cancers than the comparison group (χ 2 [2]=12.3; P =.002); this advantage was observed principally in patients younger than 70 years. Surgical staging revealed that the cancer was microscopically focal and well differentiated (possibly latent cancer) in 2.5% (1/40) of the nonscreened group, 2.9% (7/244) of the initially screened group, and 7.8% (10/129) of the serially screened group (generalized Fisher's Exact Test, P =.08). Conclusion. —Screening based on PSA identifies some men with prostate cancer who have a significantly increased proportion of organ-confined tumors compared with those detected through evaluation for an abnormal DRE alone. ( JAMA . 1993;270:948-954)
999 citations
"Various treatment options for benig..." refers background in this paper
...[1,4] The high mortality associated with these tumors is due to the fact that more than 50% of newly diagnosed patients present with advanced, metastatic disease.[5,6] Radical prostatectomy, androgen-ablation mono-therapy and radiotherapy are considered to be curative for localized disease,[7–9] but there is no effective treatment for metastatic prostate cancer that increases patient survival....
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TL;DR: In men with benign prostatic hyperplasia, terazosin was effective therapy, whereas finasteride was not, and the combination of terazOSin and finasterside was no more effective than terazoshin alone.
Abstract: Background Men with benign prostatic hyperplasia can be treated with α1-adrenergic–antagonist drugs that relax prostatic smooth muscle or with drugs that inhibit 5α-reductase and therefore reduce tissue androgen concentrations. However, the effects of the two types of drugs have not been compared. Methods We compared the safety and efficacy of placebo, terazosin (10 mg daily), finasteride (5 mg daily), and the combination of both drugs in 1229 men with benign prostatic hyperplasia. American Urological Association symptom scores and peak urinary-flow rates were determined at base line and periodically for one year. Results The mean changes from base line in the symptom scores in the placebo, finasteride, terazosin, and combination-therapy groups at one year were decreases of 2.6, 3.2, 6.1, and 6.2 points, respectively (P<0.001 for the comparisons of both terazosin and combination therapy with finasteride and with placebo). The mean changes at one year in the peak urinary-flow rates were increases of 1.4, 1...
749 citations
"Various treatment options for benig..." refers background in this paper
...One more study[42] concluded that the combination of terazosin and finasteride was no more effective than the alpha-blocker terazosin used alone....
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TL;DR: The 4-yr CombAT data provide support for the long-term use of dutasteride and tamsulosin combination therapy in men with moderate-to-severe LUTS due to BPH and prostatic enlargement.
619 citations
"Various treatment options for benig..." refers methods in this paper
...[40] The 4-yr CombAT data provide support for the long-term use of dutasteride and tamsulosin combination therapy in men with moderate-to-severe LUTS due to BPH and prostatic enlargement.[41]...
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