Following Radiation In Prostate Cancer, Risk Markers Discovered For Erectile Dysfunction

Main Category: Prostate / Prostate Cancer
Also Included In: Erectile Dysfunction / Premature Ejaculation;  Radiology / Nuclear Medicine
Article Date: 29 Sep 2012 – 0:00 PDT

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Following Radiation In Prostate Cancer, Risk Markers Discovered For Erectile Dysfunction

In the first study of its kind, a research team led by Mount Sinai School of Medicine and Albert Einstein College of Medicine of Yeshiva University discovered 12 genetic markers associated with the development of erectile dysfunction (ED) in prostate cancer patients who were treated with radiation. The findings, published online in advance of the October 1, 2012 print issue in the International Journal of Radiation Oncology• Biology• Physics, the official scientific journal of the American Society for Radiation Oncology, are an important step towards helping clinicians determine the best course of treatment for prostate cancer patients and may lead to the development of therapies that alleviate side effects.

The main treatments for prostate cancer – surgery, brachytherapy (seed implants) and external beam radiation therapy – are all very effective at curing prostate cancer. Unfortunately, each treatment places patients at risk for ED. According to the National Cancer Institute, the prevalence of erectile dysfunction following external beam radiation for prostate cancer ranges from 65 percent to 85 percent. The Prostate Cancer Foundation estimates prevalence of ED following seed therapy at 25 to 50 percent. Many men will be able to regain their potency with time and treatments, but doctors would like to identify which men may be more likely to develop this side effect.

In the first large scale Genome-Wide Association Study to identify single nucleotide polymorphisms (SNPs) associated with susceptibility for the development of erectile dysfunction following radiotherapy for prostate cancer, researchers conducted a two-part study, first, to discover the candidate genetic markers of side effect risk, and second, to confirm which of those markers are replicated in a second group of patients. In the first group of prostate cancer patients, which included 132 men who developed erectile dysfunction after radiotherapy and 103 men similarly treated who did not develop erectile dysfunction, they found a set of genetic markers associated with erectile dysfunction. In the second part of the study, which examined 128 patients who developed erectile dysfunction after radiotherapy and 102 who did not, researchers confirmed that 12 SNPs were associated with erectile dysfunction.

“Thankfully, current treatments for prostate cancer offer excellent rates of long-term survival, so patients and their physicians have a choice about which treatment path to take,” said Barry Rosenstein, PhD, Professor of Radiation Oncology, Mount Sinai School of Medicine. “However, the risk of developing erectile dysfunction after radiation treatment is highly variable, suggesting there may be a genetic component to determining that risk. Our study confirms that specific markers make certain patients more susceptible to this side effect.”

Patients in the study cohort were given one of three treatments: internal radiotherapy, known as brachytherapy; brachytherapy plus external beam radiation; or external beam radiation alone. They were followed for an average length of nearly four years to determine level of sexual function after treatment.
Interestingly, the 12 SNPs identified in this study were located near genes that seem to be related to erectile function rather than related to radiation response. The researchers conclude that these SNPs may affect genes that sensitize a patient to developing erectile dysfunction when exposed to radiation during therapy.

“Prostate cancer screening and treatment are undergoing major shifts,” said Harry Ostrer, MD, Professor of Pathology and Genetics at Albert Einstein College of Medicine and Director of Genetic and Genomic Testing at Montefiore Medical Center and co-principal investigator of the study. “This is part of our ongoing effort to identify men at highest risk for disease, identify the aggressive tumors that would be responsive to therapy, and to improve quality of life for men with indolent prostate cancers who might benefit from active surveillance, rather than therapy.”

The authors indicate that examination of a large, independent cohort of similarly treated patients will be necessary to definitively determine which SNPs to include as part of a clinically useful predictive test to identify which men are at greatest risk for developing erectile dysfunction following prostate cancer radiotherapy. The researchers are also evaluating the impact of radiation treatment on urinary complications and proctitis, the inflammation of the rectum.

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our prostate / prostate cancer section for the latest news on this subject.
This study was supported by the American Cancer Society, United States Department of Defense, and the National Institutes of Health.
The Mount Sinai Hospital / Mount Sinai School of Medicine
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Predicting Erectile Dysfunction From Prostate Cancer Treatment

Main Category: Prostate / Prostate Cancer
Also Included In: Erectile Dysfunction / Premature Ejaculation
Article Date: 27 Sep 2012 – 1:00 PDT

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Researchers have identified 12 DNA sequences that may help doctors determine which men will suffer from erectile dysfunction (ED) following radiation therapy for prostate cancer. Identifying these patients in advance of treatment may better inform men and their families as to which prostate cancer treatments are best for their specific cancer and lifestyle, according to a study to be published online September 27, 2012, in advance of the October 1, 2012 print issue, in the International Journal of Radiation Oncology• Biology• Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO). The findings could also guide doctors in recommending the most effective treatments that carry the least risk of patients developing ED.
The main treatments for prostate cancer – surgery, brachytherapy (seed implants) and external beam radiation therapy – are all very effective at curing prostate cancer. Unfortunately, each treatment places patients at risk for ED. Although many men will maintain their potency, doctors would like to identify which men are at greatest risk for the development of difficulty with sexual function.
In this multi-institutional, multi-national study, researchers from New York’s Mount Sinai School of Medicine, Albert Einstein College of Medicine of Yeshiva University in Bronx, N.Y., New York University School of Medicine, Florida Radiation Oncology Group in Jacksonville, Fla., and Maastricht University Medical Center in Maastricht, the Netherlands, examined 593 men who were treated with brachytherapy and/or external beam radiation therapy and hormone therapy. Of them, 260 reported erectile dysfunction.
“Through a two-stage genome-wide association study, 12 single nucleotide polymorphisms (SNPs) were identified that were associated with the development of erectile dysfunction after radiation treatment for prostate cancer,” said Barry S. Rosenstein, PhD, department of radiation oncology at New York’s Mount Sinai Medical School. “If validated further, these SNPs could provide the basis for a blood test that would enable radiation oncologists to predict more accurately which men are most likely to develop erectile dysfunction after prostate cancer radiation therapy.”
“Prostate cancer screening and treatment are undergoing major shifts,” said Harry Ostrer, MD, professor of pathology and genetics at Albert Einstein College of Medicine, director of genetic and genomic testing at Montefiore Medical Center and co-principal investigator of the study. “This is part of our ongoing effort to personalize and optimize treatment for prostate cancer.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our prostate / prostate cancer section for the latest news on this subject.
Disclosures: One author (NS) reports to have received consulting fees or honoraria from Amgen, Ferring, Janssen, Diversified Conference Management, Prologics LLC, and Nihon MediPhysics. Another author (RS) has received fees for developing lectures and educational materials for Bard.

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Please use one of the following formats to cite this article in your essay, paper or report:

n.p. “Predicting Erectile Dysfunction From Prostate Cancer Treatment.” Medical News Today. MediLexicon, Intl., 27 Sep. 2012. Web.
27 Sep. 2012. <http://www.medicalnewstoday.com/releases/250722.php>
n.p. (2012, September 27). “Predicting Erectile Dysfunction From Prostate Cancer Treatment.” . Retrieved fromhttp://www.medicalnewstoday.com/releases/250722.php.

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Prostate cancer is a disease which only affects men. Cancer begins to grow in the prostate – a gland in the male reproductive system. The word “prostate” comes from Medieval Latin prostate and Medieval French prostate. Read more…

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