Unfortunately, men with our disease have no organization to lobby on our behalf. In researching articles for this site, I frequently come across what I think are promising approaches to our disease, but they never get beyond my comments on this site due to lack of advocacy. I publish these articles as more of a mental exercise than harboring any expectations that they will be tested for the treatment of our disease. In reading about the following medications remember that PD is considered a wound healing disorder associated with fibrotic changes (scar tissue) usually resulting in erectile dysfunction. An adequate level of nitric oxide is critical for wound healing and the vasodilation required for an erection, So at least in theory, any substance that will moderate or reverse fibrotic changes or lead to an adequate supply of nitric oxide should be of benefit to us.
Queens University in England published an article on the use of a very low dose nitroglycerine patch to slow and even halt progression of prostate cancer. Seventeen men who had prostate cancer treatment, but continued to exhibit rising PSA levels were treated with a low a dose nitroglycerine patch. All but one showed a stabilization or decrease in the rate of cancer progression as measure by PSA activity. What does nitroglycreine have to do with a PD treatment? Nitroglycerine is converted to nitric oxide in the body.
Increased levels of nitric oxide maybe effective in preventing progression of PD or reversing its fibrosis as described Nat Clinical Practice Urology 2006: 3111-5, 37.
Increased nitric oxide production maybe the reason why pentoxiflylline has been shown to be somewhat effective in treating early PD.
Nitroglycerine is converted into nitric oxide in the body. To me, a non scientist, this sounds like an inexpensive, safe approach to attempt to treat PD, especially in its earliest stages.
According to an article in Prostate Cancer Discovery, The Brady Urological Institute, Winter 2010, erythropoietin, is a hormone made in the kidney. It has been shown to preserve nerve function after an injury and preliminary studies show that it may help to preserve erectile function after a Radical Prostatectomy. In a separate article, The American Journal of Pathology, 2003 reported that this substance was related to wound healing in laboratory rats.
This is a common erectile dysfunction drug and was tested on patients with Idiopathic Pulmonary Fibrosis(IPF). IDF is a fatal fibrotic disorder of the lungs. Testing on 180 patients did present some positive, secondary outcomes in the areas of shortness of breath and quality of life. I have written a number of previous articles about evidence that common ED drugs exhibit anti-firbrotic properties, particularly during the early stages of PD and maybe a useful treatment. The fact that it did help somewhat with another fibrotic disorder IDF, is an encouraging sign.
Frozen Shoulder (adhesive capsulitis) and what it maybe able to tell us about what to do and what to avoid
Frozen shoulder and PD are disorders that appear to have much in common
Both are connective tissue disorders resulting from an injury, leading to inflammation, scarring and tissue shrinkage. In the case of frozen shoulder, it results in shrinkage of the capsule that surrounds the normal shoulder joint
Both occur more frequently in men with diabetes
It is believed that both have an autoimmune component
Xiaflex is being tested as a PD treatment and it is being considered for testing on frozen shoulder
Stretching exercises are usually recommended for patients with a frozen shoulder. They exercises invariably involve stretching the injured arm towards the outward, non deformed position.
What does this have to do with our disorder? Physicians who treat men with PD will recommend that they remain sexually active. What exactly does this mean? In contrast to stretching outward towards the non-deformed position as with a frozen shoulder, during actual vaginal intercourse, the penis is tensed and via thrusting significant pressure is applied against the penis towards the direction of the deformed position. Particularly during the active phase of the disease this may result in further injury to the penis. When I first contracted this disease, I remained sexually active and engaged in vigorous vaginal intercourse and my condition worsened considerably. Did this pressure account for the worsening of my condition? I don’t really know, but logic and common sense would not rule out this explanation. Let me know what you think.
I was in the earlier stage of the clinical trial for this drug and received the placebo resulting in absolutely no change in my condition. Recently, I was called by the trial site nurse informing me that further testing will begin sometime in September 2010. If you are interested, check the site clinicaltrials.gov for any announcement.