The most deadly forms of enlarged prostate may need to be reclassified as their own disease, according to research coming out of Johns Hopkins.
The good news is that a simple blood test can differentiate between variants of the disease that can lead to kidney damage and those which will cause relatively little discomfort, said Robert Getzenberg, director of research of the James Buchanan Brady Urological Institute and professor of urology at the Johns Hopkins University School of Medicine.
“When we started our studies several years ago, we thought [enlarged prostate disease] was all the same disease,” Getzenberg said. “At the genetic level, the disease in someone who has mild or no symptoms is a different disease.”
Millions of middle-aged and older men experience the symptoms of an enlarged prostate ? frequent and urgent urination ? multiple times during the day and night, according to the National Institutes of Health. Prostate enlargement affects almost all men as they age and the gland grows. The prostate eventually can press on the urethra and cause urination and bladder problems.
In a study published in the February issue of the Journal of Urology, Getzenberg and other Hopkins researchers reported substantially higher levels of a protein made by the gene JM-27 in men with severe prostate conditions.
In these cases, Getzenberg said, the prostate blocks urination, putting pressure on the bladder and ultimately the kidneys.
The blood test devised by his team at Hopkins detects approximately 90 percent of men with the severe disease and gives false positives in 23 percent of the cases, according to the article.
Currently, doctors treat an enlarged prostate with two classes of drugs: alpha blockers to relax the prostate and 5-alpha reductase inhibitors to help to shrink it, according to the article. Unresponsive cases frequently require surgery.
“The next step is to figure out which drugs work best on which form of the disease as differentiated by JM-27,” Getzenberg said.
If approved by the FDA, a blood test could help identify severe prostate disease early, before it damages the bladder or urinary tract, he said.
