ACHIEVEMENTS
ANZUP ANNUAL REPORT 2022
Below the Belt Research Fund The Below the Belt Research Fund has supported many members in the development of investigator-initiated studies. This year, it has provided much needed seed funding to support four ANZUP members to progress new trial ideas to the point of becoming full scale studies. We would like to congratulate the recipients and following you can read about these studies. DR CIARA CONDUIT, MEDICAL ONCOLOGIST, PETER MACCALLUM CANCER CENTRE
Ciara Conduit: Exploring the activity of pseudoephedrine in treating retrograde ejaculation following retroperitoneal lymph node dissection in survivors of testicular cancer (PREPARE) Testicular cancer (TC) is one of the most common cancers diagnosed in young men in Australia. While most men can expect a positive outcome, treatment can result in long-term side effects.
DR MEGAN CRUMBAKER, ST. VINCENT’S HOSPITAL SYDNEY
Megan Crumbaker: A Phase II study of high dose testosterone in combination with carboplatin in men with metastatic castrate-resistant prostate cancer Prostate cancer that has spread beyond the prostate and its nearby areas is usually incurable and targeted with treatment that lowers testosterone, called ADT. ADT is associated with several side effects,
Sometimes after retroperitoneal lymph node dissection (RPLND; surgery involving the lymph nodes at the back of the abdomen), important nerves controlling ejaculation can become disrupted. This results in retrograde ejaculation (RE), where sperm flows back into the bladder instead of through the penis after orgasm. It is sometimes called a dry orgasm. Although RE is not harmful or painful, it may affect sensation during orgasm and result in infertility (difficulty conceiving a pregnancy). While RE may resolve spontaneously in some men, it becomes a chronic problem for others and existing treatments are not standardised, nor always helpful or successful. We plan to conduct a pilot study exploring the effectiveness of an oral medication, pseudoephedrine (an ingredient in ‘Cold and Flu’ tablets), to improve RE
including some that worsen over time on treatment. Though effective initially, prostate cancers generally become resistant to ADT eventually. This resistance allows the cancer to grow, causing symptoms, such as pain, and shortened lifespan. Research shows that prostate cancer cells in the lab can adapt to ADT in ways that make them vulnerable to attack from high testosterone levels. Recent prostate cancer trials used pulses of testosterone in men with ADT-resistant cancer to try to shrink the cancer and improve men’s overall wellbeing. The research found that the treatment is safe, associated with improved quality of life and has anti-cancer effects. Based on this research and other research into the effect of testosterone on resistant
following RPLND. As pseudoephedrine causes tightening of the bladder muscle, it prevents sperm flowing back into the bladder and thus helps sperm move through the penis. It is therefore a potentially effective treatment for RE. Whilst some studies in men with RE due to other causes have shown pseudoephedrine may be helpful, it is not known how effective this approach is for men with RE after RPLND. We are currently undertaking a study to help understand how common RE is after RPLND, and how it affects men’s health-related quality of life (HRQoL). To follow up, we would like to recruit men with RE following RPLND and explore the effectiveness of pseudoephedrine as a treatment and improve our understanding of the impacts that RE has on HRQoL for survivors of TC.
prostate cancer cells, we hypothesise that adding a particular chemotherapy drug, carboplatin, will enhance the effectiveness of testosterone treatment without compromising quality of life. We have treated 9 men with the combination of testosterone and carboplatin. Many of the patients on this pilot study report feeling much better due to an increase in their testosterone levels. The treatment has also stopped the growth of some men’s cancer. We would like to use funding from this grant to expand the study to other cancer centres to improve access to this novel treatment, assess the effectiveness of the treatment, and determine whether a larger trial comparing it against other prostate cancer treatments would be worthwhile.
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