Symptoms

Early prostate cancer often doesn't exhibit any symptoms so regular examinations are especially important. When symptoms do occur, they may include:

• Frequent urination
• Difficulty starting or stopping urination
• Inability to urinate
• Weak or interrupted flow of urine
• Painful or burning urination
• Painful ejaculation
• Blood in urine or semen
• Persistent pain in lower back, hips, upper thighs.

Researchers with the Holden Comprehensive Cancer Center are leading the nation's first-ever clinical trial of an adenovirus/prostate specific antigen vaccine.

The vaccine trial shows promise as one of the new generation of therapies designed to help a patient's immune system redirect its efforts at fighting prostate cancer cells, even when those cells have metastasized throughout the body.

"I have high expectations and every reason to think gains will be made in this area," said Jack Leonard of Lisbon, Iowa, one of the phase I volunteers. The 69-year-old father of five was first diagnosed with prostate cancer in 1996 and has been treated with surgery and hormone therapy, and is now a pioneer member of the clinical trial.

"If they can hold the cancer in check, or even better, knock it down, that would be great," Leonard said. "Or better yet, develop a vaccine to be given at a certain age and never worry about prostate cancer again."

The lead researchers on the project are David Lubaroff, Ph.D., Badrinath Konety, M.D., Brian Link, M.D., and Richard Williams, M.D.

Investigators Tim Ratliff, Ph.D., and Tom Griffith, Ph.D., are developing further prostate cancer vaccines and will begin additional trials within the next year.

Keeping alert
Vigilance helps men avoid the risks of prostate cancer

Eight years have passed since Tom Shepherd answered a newspaper advertisement seeking volunteers for a study of prostate cancer.

"The trial sounded like a way to get an annual checkup and help someone in the future, so I signed up," he said. "It seemed like a win-win situation."

Shepherd's participation in that trial is over, but his volunteer spirit remains alive and well. He recently enrolled in a different clinical trial, this one evaluating the effectiveness of selenium and vitamin E in helping men avoid the disease.

Preliminary research shows vitamin E and the mineral selenium reduce prostate cancer by 30 to 60 percent, possibly blocking mutation at the molecular level.

"I have no family history of prostate cancer," Shepherd said. "In fact, my father lived to be 94 and he never had it, although at his age he probably did have it and didn't know it. The important thing is for men to get their checkups and stay on top of it."

The National Cancer Institute began the selenium and vitamin E trial (nicknamed SELECT) last year, hoping to enroll more than 32,000 men. That number almost duplicates the number of American men who die of prostate cancer each year--31,000.

The Holden Comprehensive Cancer Center at The University of Iowa is one of 400 centers nationwide participating in the 12-year study, which seeks to involve men over the age of 55 and African-American men over age 50.

Richard Williams, M.D., professor and head of the Department of Urology, said, "The good news is that the incidence rate of prostate cancer has decreased by 5.1 percent and the death rate has decreased by 3.5 percent between 1992 and 1998, suggesting that screening may work. The research we're doing in this area is helping advance our understanding of how to treat and prevent prostate cancer."

For more information about the SELECT or prostate cancer in general, contact the Holden Cancer Center Information Service at 800-237-1225, or visit www.uihealthcare.com/urology.