Gene drug may help erectile nerves grow back after prostate cancer surgery, rat study finds

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These microscopic images show how damaged nerves grow back more efficiently when treated with gene therapy (right) compared to those left to grow back naturally (left)



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Scientists say an experimental nerve-growing drug could revolutionize the sex lives of people with prostate cancer.

Thousands of men diagnosed with the disease need drastic treatment to remove the organ, which is located in the pelvis and is about the size of a ping-pong ball. But it can damage the nerves that control blood supply to the penis, leaving patients completely unable to get an erection – even while using Viagra.

Now, researchers believe hope may finally come in the form of a drug that allows impotent patients to get erections again.

A study in rats with similar nerve damage found that an overactive gene slowed down the body’s ability to heal damaged nerves.

But a spray drug that blocked the gene helped speed it up in rodents and reduced their ability to get erections, according to the New York team of experts.

The rat study now suggests that the drugs could dramatically improve recovery and even bring men’s sexual function back to normal. However, it has not yet been tested on humans.

Many men who need drastic treatment to remove their prostate, which is in the pelvis and is about the size of a ping-pong ball (highlighted in yellow), find themselves with problems life (stock image)

These microscope images show how damaged nerves grow back more efficiently when treated with gene therapy (right) compared to those left to grow back naturally (left)

These microscopic images show how damaged nerves grow back more efficiently when treated with gene therapy (right) compared to those left to grow back naturally (left)

The researchers behind the discovery claim that 60% of men who have prostate removal surgery still suffer from erectile dysfunction 18 months later.

And less than one in three can have erections good enough to have sex in five years.

Nerve transplant surgery can improve this, but it’s a random procedure, and letting the nerves grow back naturally may take years or never happen.

Prostate cancer is the most common form of the disease in British men, accounting for about one in four cancer cases – about 50,000 per year and 250,000 per year in the United States.

“Despite so-called nerve-saving procedures, surgery can damage the cavernous nerves, which control erectile function by regulating blood flow to the penis,” said Dr. Kelvin Davies, of the Albert Einstein College of Medicine in New York.

The prostate is a small organ surrounded by other tissue, so surgery to remove it inevitably involves pushing and disturbing other parts of the body.

Nerves are fragile, and squeezing, pulling, or damaging them with tools like scalpels can affect how they work. This can lead to numbness or muscle weakness.

The body can heal the nerves on its own, but researchers at Albert Einstein found that a particular gene, called FL2, slows this down.

FL2 prevented skin cells from trying to reach damaged nerves to rebuild them.

Dr Davies and his colleagues developed a drug that could stop FL2 from working and found that it sped up the process of nerve healing.

It was given with the help of siRNA – “small interfering RNA molecules” that provide genetic material that interferes with the body’s ability to make FL2.

Prostate cancer is the most common form of the disease in British men, accounting for around one in four cancer cases - around 50,000 per year

Prostate cancer is the most common form of the disease in British men, accounting for around one in four cancer cases - around 50,000 per year

Prostate cancer is the most common form of the disease in British men, accounting for around one in four cancer cases – around 50,000 per year

Three weeks after receiving the anti-FL2 drug, siRNA therapy in a gel that was sprayed onto the nerves, the rats had “significantly better erectile function” compared to the untreated rats.

And after a month of treatment, the researchers found that the treated rats had normal blood pressure levels in their penises.

Even rats that had their nerves completely severed managed to partially repel them in seven out of eight cases.

In humans, severed nerves are much less likely to recover, and when they do, it can take years.

Dr David Sharp, Co-Head of Research, said: “Erectile dysfunction after radical prostatectomy has a major impact on the lives of many patients and their partners.

“Since rats are reliable animal models in urological research, our drug offers real hope for normal sexual function for the tens of thousands of men who undergo this surgery each year.

The researchers also found that using the drug may increase the likelihood that taking pills like Viagra will work, as it increases the levels of a chemical vital to achieving an erection.

Nitric oxide, which causes penile muscles to relax and allows blood to circulate, was found in greater amounts in rats treated with siRNA.

“It’s important because drugs like Viagra don’t work if there’s no nitric oxide to get it going,” said Dr Sharp.

“But if we can restore even some of the nitric oxide to these nerves, then Viagra and other erectile dysfunction drugs may be able to work. ”

The study was published in the journal JCI Insight.

WHAT IS PROSTATE CANCER?

How many people does he kill?

More than 11,800 men a year – or one every 45 minutes – are killed by the disease in Britain, compared with around 11,400 women who die from breast cancer.

This means that prostate cancer is only behind the lungs and intestines in terms of the number of people it kills in Britain.

In the United States, the disease kills 26,000 men each year.

Despite this, it receives less than half of breast cancer research funding, and treatments for the disease are at least a decade behind schedule.

How fast is it growing?

Prostate cancer usually grows slowly, according to the NHS, so there may be no signs that someone has had it for many years.

If the cancer is at an early stage and is not causing symptoms, a policy of “watchful waiting” or “active surveillance” may be adopted.

Some patients can be cured if the disease is treated at an early stage.

But if it’s diagnosed at a later stage, when it has spread, it becomes terminal and treatment revolves around symptom relief.

Thousands of men are discouraged from seeking a diagnosis because of the known side effects of treatment, including erectile dysfunction.

Tests and treatment

Prostate cancer screening tests are hit and miss, and specific tools are only just beginning to appear.

There is no national prostate screening program because for years the tests are too imprecise.

Doctors find it difficult to distinguish between aggressive and less severe tumors, which makes it difficult to choose treatment.

Men over 50 are eligible for a “PSA” blood test which gives doctors a rough idea of ​​whether a patient is at risk.

But it is not reliable. Patients who test positive usually receive a biopsy which is also not foolproof.

Scientists aren’t sure what causes prostate cancer, but age, obesity, and lack of exercise are known risks.

Anyone with concerns can speak to Prostate Cancer UK specialist nurses on 0800 074 8383 or visit prostatecanceruk.org

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