Urologist awarded research funds to study herbal remedies for prostate and urinary diseases

Kingston, ON December 16, 2003 For the first time in North America, non-traditional methods of treating painful prostate and bladder diseases that are expected to affect more than 50% of the adult population will be scientifically studied by a Queen’s University-based research team working out of Kingston General Hospital (KGH).

Dr J Curtis Nickel, professor of urology at Queen’s and urologist at KGH, has been awarded four research grants from the US National Institutes of Health (NIH), totaling almost $8 million. He and his Kingston genito-urinary research group will examine alternative, complementary and novel therapies for prostate and bladder disease, in both laboratory research and clinical trials that will involve more than 3,000 men and women throughout southern Ontario.

"For these diseases, traditional medicine has offered all it can," says Dr Nickel. "Alternative herbal therapies which people have been using for more than 4,000 years complementary therapies, and radically novel treatments must be evaluated by traditional clinical scientists, to determine their true effectiveness and safety."

The NIH, which coordinates all government health care research in the United States, has been directed by the US Congress to look at herbal therapies that now make up a billion-dollar industry in North America. "It’s exciting to embark on such a wide-ranging project with potential applications in so many areas," says Dr Curtis. "There are probably more herbal than prescribed pharmaceutical treatments sold in Canada today but, without clinical evaluation, we don’t know how safe they are, or whether they really work!"

The Queen’s/KGH group has taken a leading role in designing, implementing and completing local, national and international multi-centre studies in benign diseases of the urinary tract. These studies have evaluated the traditional medical therapies currently used for these conditions.

The new programs will build on findings from the group’s earlier, $2-million pilot project, also funded by NIH, that was completed earlier this year.

The new studies involve laboratory research and clinical trials in the following areas:

– Benign prostatic hyperplasia (BPH), a disease of aging men that occurs as their prostate gland grows, can affect more than 50% of men, with half of those requiring some form of traditional medication or surgery. Dr Nickel’s group plans to look at two of the most promising herbal remedies for this disease: serenoa repens (also called saw palmetto, which is extracted from the leaves of the American dwarf palm tree), and pygeum africanum (extracted from inner bark of the African pygeum tree).

– Prostatitis and interstitial cystitis are painful conditions of the prostate and bladder that can lead to devastating consequences for afflicted patients. There is no known cause and no effective treatment. The study will assess the efficacy and safety of the plant extract, quercetin, a natural anti-inflammatory agent, as well as complementary therapies such as acupuncture.

– Novel therapies, based on the most recent laboratory data that the team uncovers on these conditions, will also be developed and tested.

"One of the reasons we received these grants is that we believe the two areas of disease one mainly in women and the other in men are related," says Dr Nickel. "The treatments we’re looking at, for prostate disease in men and bladder disease in women, will be very similar."

Because the population base in southeastern Ontario could not support such large clinical trials, Dr Nickel is collaborating with two Toronto researchers who will recruit volunteers from a network of primary care urologists in private practice. The group is now conducting "stability" studies on its sources of herbal remedies a process that is valuable in itself, since it has never been done before. Trials are scheduled to begin this spring in collaboration with a number of US universities, including Harvard, Tufts, UCLA, and Pennsylvania.

The Kingston genito-urinary research group has been supported by KGH and Queen’s since its inception more than 10 years ago. Other team members in the recently funded group are Drs Alvaro Morales and Robert Siemens (urology), Dr Dean Tripp (psychology) a research fellow, a research coordinator, a research associate, an acupuncturist, and four research nurses.