When attempted, bilateral nerve sparing was achieved in 73 percent of study patients, com­pared to only 56 percent of con­trol patients. Also, CaverMap intraoperative "confirmation" of nerve function proved a good indicator of return of erectile function by a 12 months follow-up sexual function questionnaire. 

Calling it a "promising new technology," Laurence Klotz M.D., Professor of Urology at University of Toronto says, "Until now, surgeons have relied solely upon anatomical landmarks and experience to locate and avoid damaging the cavernosal nerves responsible for erectile function. Use of CaverMap... has potential...for improved nerve-sparing radical prostatectomy results." Patients facing surgery should ask their surgeons about this new technol­ogy.

Genetic Process Could be Reversible

Scientists used molecular probes to highlight and compare gene activity in cancer patients' normal prostate tissue with that of their tumors and found clear evidence the gene pp32 was switched on in normal cells but generally switched off in cancer cells. Earlier studies by the team showed pp32 acts as a suppres­sor to keep cells from turning malignant. Close relatives of the gene, pp32rl and pp32r2, encourage tumor growth and are present and were turned on in perhaps 90 percent of the cases studied. Switching could be a fundamental process in cancer, researchers say; it has already been linked with common forms of breast cancer.“If we can understand how the switching works, what controls it, we can potentially reverse it,” Pasternack says, “That’s our next task.”The team hopes to screen and find drugs for the purpose within two years.

Model Explains Increased Incidence, Higher Mortality rate in Black Men

Although incidence rates rose dramatically in both races in the early 1990's, the higher rate in blacks has been documented for more than 20 years with differ­ences most disparate in men under 65 years old. The mortality rate is also greater in blacks, again with greater disparity noted in younger men. Mortality rates are similar for blacks and whites diagnosed after age 70. 

One classic characteristic of prostate cancer in black men is later stage. Delay in detection caused by cultural issues (i.e.: access to healthcare, knowledge of the disease, economic factors, fear of therapy and distrust of a predominantly white medical establishment) may lead to a higher stage at time of initial ther­apy and a worse outcome for blacks. Data also suggests black men eat more animal fat, which is linked to greater prostate can­cer risk. Recent autopsy studies show small, latent cancers occur at similar frequency in both races between 20-80 years. Yet more high grade prostatic intraepithelial neoplasia (PIN) has been identi­fied in blacks. Increasing data also confirms that blacks have a higher androgenic stimulation as well as generally higher Gleason scores. 

Two researchers hypothesize that PIN is a precursor of Gleason grade 4 cancers: "The data sup­port a biologic etiology of increased incidence with epigenet­ic factors affecting stage at diag­nosis that could be circumvented by earlier detection. Cultural issues alone in black men would tend to lower, not raise, detec­tion and incidence; thus, a biolog­ic influence must be entertained. However, epigenetic factors such as diet, detection practices or androgenic stimulation may explain many other factors relat­ed to stage and presentation and mortality."