Prostate cancer urine test nears

14 October 2010 Last updated at 00:01 ET

British scientists have moved a step closer to developing a simple urine test to identify men at risk of getting prostate cancer.

They have discovered that a protein found in urine is affected by a genetic change linked to the cancer.

More research was needed, but their work could lead to the development of a reliable test costing �5.50.

Prostate cancer is the most common cancer in men in the UK, killing about 10,000 men in Britain every year.

There is currently no routine screening programme in the UK, although men with a family history of the disease can have a prostate specific antigen (PSA) blood test to detect signs of the disease.

But this is notoriously inaccurate and although 10-15% of men will have high enough PSA levels to warrant carrying out a prostate biopsy, only 2-3% will require any treatment.

Research published in the online journal Public Library of Science ONE showed that the protein, called MSMB, is present at reduced levels in men diagnosed with the disease.

Levels also appear to be affected by tumour aggressiveness.

Potentially 'powerful'

Study leader Dr Hayley Whitaker, from Cancer Research UK charity's Cambridge Research Institute, said: "We looked in tissue and urine from over 350 men with and without prostate cancer to find out how much MSMB they had.

"We then looked to see who had the genetic change. It was really exciting to find out that the genetic change and the amount of protein were linked.

"The protein is easy to detect because it is found in urine and would potentially be a very simple test to carry out on men to identify those most at risk of developing the disease."

Dr Kate Holmes, research manager at The Prostate Cancer Charity, described the test as "potentially... a powerful way to predict how likely a man is to develop prostate cancer".

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Walking 'could ward off dementia'

13 October 2010 Last updated at 20:51 ET

Elderly people who get about by walking are less likely to suffer mental decline or even dementia, a study says.

Brain scans revealed that older people walking between six and nine miles a week appeared to have more brain tissue in key areas.

The Pittsburgh University study of 299 people suggested they had less "brain shrinkage", which is linked to memory problems.

The research was reported in the journal Neurology.

The volunteers, who had an average age of 78, were checked for signs of "cognitive impairment" or even dementia.

The Pittsburgh team also had access to brain scan results from four years previously which measured the amount of "grey matter" in their brains.

Brain health

This is found at various parts of the brain and is known to diminish in many people as they get older.

Each of them had been quizzed in their 60s about the number of city blocks they walked each week as part of their normal routine.

The results showed that those who walked at least 72 blocks - six to nine miles - a week had a greater volume of grey matter.

Four years after the scans, 40% of the group had measurable cognitive impairment or even dementia.

Those who walked the most were half as likely to have these problems compared with those who walked the least.

Dr Kirk Erickson, who led the study, said: "If regular exercise in midlife could improve brain health and improve thinking and memory in later life, it would be one more reason to make regular exercise in people of all ages a public health imperative."

Susanne Sorensen, from the Alzheimer's Society, said that the study was further evidence that a healthy heart could lead to a healthy brain.

She added: "One of the benefits of this research is that it eliminates the impact other socio-economic factors may play and focuses specifically on walking rather than exercise more generally.

"Although a link has been found between lack of exercise and brain shrinkage, we need more research to find out why physical activity may affect the brain.

"The best way to reduce your risk is to take regular exercise, eat healthily, don't smoke and get your blood pressure and cholesterol checked."

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Love 'is a drug which eases pain'

13 October 2010 Last updated at 20:29 ET

Love hurts, at least according to many a romantic songwriter, but it may also help ease pain, US scientists suggest.

Brain scans suggest many of the areas normally involved in pain response are also activated by amorous thoughts.

Stanford University researchers gave 15 students mild doses of pain, while checking if they were distracted by gazing at photos of their beloved.

The study focused on people early in a romance, journal PLoS One reported, so the "drug of love" may wear off.

The scientists who carried out the experiment used "functional magnetic resonance imaging" (fMRI) to measure activity in real-time in different parts of the brain.

It has been known for some time that strong feelings of love are linked to intense activity in several different brain regions.

These include areas linked to the brain chemical dopamine, which produces the brain's feel-good state following certain stimulants - from eating sweets to taking cocaine.

"Light up"

The Stanford University researchers had noticed that when we feel pain, some of the same areas "light up" on the scans - and wondered whether one might affect the other.

They recruited a dozen students who were all in the first nine months of a relationship, defined as "the first phase of intense love".

Each was asked to bring in a picture of the object of their affection and photos of what they deemed an equally attractive acquaintance.

Continue reading the main story

"Start Quote

It's important to recognise that people who feel alone and depressed may have very low pain thresholds, whereas the reverse can be true for people who feel secure and cared for"

End Quote Professor Paul Gilbert University of Derby

While their brains were scanned, they were shown these pictures, while a computer controlled heat pad placed in the palm of their hand was set up to cause them mild pain.

They found that viewing the picture of their beloved reduced perceptions of pain much more than looking at the image of the acquaintance.

Dr Jarred Younger, one of the researchers involved, said that the "love-induced analgesia" appeared to involve more primitive functions of the brain, working in a similar way to opioid painkillers.

"One of the key sites is the nucleus accumbens, a key reward addiction centre for opioids, cocaine and other drugs of abuse.

"The region tells the brain that you really need to keep doing this."

Professor Paul Gilbert, a neuropsychologist from the University of Derby, said that the relationship between emotional states and the perception of pain was clear.

He said: "One example is a footballer who has suffered quite a painful injury, but who is able to continue playing because of his emotionally charged state."

He added that while the effect noticed by the Stanford researchers might only be short-lived in the early stages of a love affair, it may well be replaced by something similar later in a relationship, with a sense of comfort and wellbeing generating the release of endorphins.

"It's important to recognise that people who feel alone and depressed may have very low pain thresholds, whereas the reverse can be true for people who feel secure and cared for.

"This may well be an issue for the health service, as patients are sometimes rushed through the system, and perhaps there isn't this focus on caring that might have existed once."

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Public 'misled' over drug trials

13 October 2010 Last updated at 03:31 ET By Michelle Roberts Health reporter, BBC News

Doctors and patients are being misled about the effectiveness of some drugs because negative trial results are not published, experts have warned.

Writing in the British Medical Journal, they say that pharmaceutical companies should be forced to publish all data, not just positive findings.

The German team give the example of the antidepressant reboxetine, saying publications have failed to show the drug in a true light.

Pfizer maintains its drug is effective.

Reboxetine (Edronax), made by Pfizer, is used in many European countries, including the UK.

But its rejection by US drug regulators raised doubts about its effectiveness, and led some to hunt for missing data.

This is not the first time a large drug company has come under fire about its published drug trial data.

Trial information

Pharmaceutical giant GlaxoSmithKline (GSK) was criticised for failing to raise the alarm on the risk of suicidal behaviour associated with its antidepressant Seroxat.

GSK rejected claims that it improperly withheld drug trial information.

Continue reading the main story

"Start Quote

Our findings underline the urgent need for mandatory publication of trial data"

End Quote The research authors

But GSK has also been forced to defend itself over allegations about hiding negative data regarding another of its drugs, Avandia, which is used to treat diabetes.

Now researchers from The German Institute for Quality and Efficiency in Health Care say there is unpublished trial data for Pfizer's antidepressant reboxetine that should be made public because it could change views about the drug.

Dr Beate Wieseler and colleagues carried out their own assessment of reboxetine, looking at the results of 13 trials, including eight previously unpublished trials from the manufacturer Pfizer.

They found the drug was no better than a placebo in terms of remission and response rates. And its benefit was inferior when compared with other similar antidepressants.

Furthermore, a higher rate of patients had side effects with reboxetine than with placebo. And more stopped taking the drug because of side effects compared with those taking a placebo or a different antidepressant.

Biased picture

The researchers said there has been a publication bias and this had overestimated the benefit of reboxetine and underestimated potential harm. And, they said, it was a widespread problem that applied to many of the drugs in use today.

"Our findings underline the urgent need for mandatory publication of trial data," they say in the BMJ.

They warn that the lack of all information means policy makers are unable to make informed decisions.

In the US, it is already a requirement that all data - both positive and negative - is published. The UK is also striving to achieve this.

The UK's regulator, the MHRA, said: "There is a European initiative to provide public access to the results of clinical trials. The currently planned timeline is that this information could become available in late 2011/early 2012."

A spokeswoman for Pfizer said: "In the UK, Pfizer's reboxetine is licensed for the acute treatment of depressive illness/major depression and for maintaining the clinical improvement in patients initially responding to treatment.

"This medicine presents an effective treatment option to clinicians for the use in patients suffering from these conditions.

"Pfizer discloses the results of its clinical trials to regulatory authorities all around the world. These regulatory authorities carefully balance the risks and benefits of each medication, and reflect all important safety and efficacy information in the approved product labelling.

"Pfizer will review the meta-analysis relating to reboxetine published in the British Medical Journal on 13th October 2010 in detail and will provide further comment after completing the review."

Others lay at least some of the blame with the medical journals that publish drug trial data.

In response, the BMJ has promised to devote an entire issue to the topic next year.

BMJ Editors Dr Fiona Godlee and Dr Elizabeth Loder said: "It is time to demonstrate a shared commitment to set the record straight."

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