Asthma sufferers who regularly use an inhaler to ease their symptoms could be at greater risk of prostate cancer, a study indicates.
Researchers found that male asthma sufferers who use inhalers are up to 40 per cent more likely to develop tumours than men without the condition.
Merely having asthma increases a man’s likelihood of developing prostate cancer by 26 per cent.
Those who regularly use another type of inhaler – a bronchodilator – to relieve wheezing are 36 per cent more at risk of the disease.
But the biggest danger appears to be among men with severe asthma who frequently need treatment with steroid tablets or injections.
Asthma inhaler
Among this group, according to the study, the risk of cancer increases by up to 70 per cent.
Asthma sufferers using bronchodilators will usually have two types – one which provides instant relief from symptoms and another to use once or twice day to prevent them developing in the first place.
Around 5.2 million people in Britain have asthma. According to Asthma UK, it kills one person every seven hours and leaves 70,000 a year needing hospital treatment.
Nearly 32,000 cases of prostate cancer are diagnosed every year in the UK and 10,000 men die from it.
Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs.
When a person with asthma comes into contact with something that irritates their airways (an asthma trigger), the muscles around the walls of the airways tighten so that the airways become narrower and the lining of the airways becomes inflamed and starts to swell. Sometimes sticky mucus or phlegm builds up which can further narrow the airways. The illustration on the right shows a cross section of the airways, with and without inflammation.
All these reactions cause the airways to become narrower and irritated – making it difficult to breath and leading to symptoms of asthma.
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Three quarters of hospital admissions due to asthma would be avoidable if the condition was managed properly, according to a charity.
Asthma UK Scotland has published figures which showed 6,000 people go to accident and emergency each year after suffering an asthma attack.
It said there had been no improvement for a decade, costing the NHS £100m.
The charity, which has published a new guide for people with asthma, said new approaches were urgently needed.
It has urged people with asthma to follow guidelines on proper care, and has asked health boards to review how they monitor asthma in the community.
Asthma UK Scotland said the cost of an emergency admission was three and a half times more that the cost of treating somebody in primary care, and amounted to more than £10m a year.
The charity’s director, Gordon Brown, told BBC Radio Scotland’s Good Morning Scotland programme that a number of people needed to be involved in managing the condition not least the person with asthma themselves.
He said: “The underlying message is a dialogue, a dialogue between health professionals, people with asthma and hopefully sharing the burden of care.”
A new genetic study has revealed that allergies are an outcome of asthma, not a cause of it.
Scientists have also found seven genes linked to the development of the ailment, which could lead to new treatments, reports the Sydney Morning Herald.
Researchers from Imperial College London and colleagues around the world carried out more than half a million genetic tests on 26,000 subjects.
The findings have suggested that allergies are a consequence of asthma, which causes damaged airways.
They also found that adult-onset asthma and childhood asthma were different diseases.
But the head of respiratory and environmental epidemiology at the Woolcock Institute in Sydney, Guy Marks, said he did not think the study had definitively shown that allergies were a consequence of asthma, not the cause.
””That is the conclusion the authors have drawn but I would be a bit more cautious,”” he said.
He believed this type of research – including other genetic studies of asthma being conducted among Australians – might lead to better-targeted treatments and ways to prevent asthma in the first place.
The research highlighted that asthmatics were better off finding a medication that worked for them than trying to avoid potential allergens, , said Michele Goldman of the Asthma Foundation NSW.
The genes were found in a third of children with asthma. Some were involved in activating the immune system; others were linked to breathing. This means treatments could be designed to correct their function.
William Cookson, of Imperial College London, who co-ordinated the research, said: ””Our study highlights targets for asthma therapies and suggests that therapies against these targets will be of use to many asthmatics.”
The findings were published in The New England Journal of Medicine.
A large international study has revealed several genetic variants which are linked to people with asthma.
In all, more than 500,000 tests were performed on the genes of 10,000 children and adults with the condition, and 16,000 non-asthmatics.
The Imperial College-led research, published in the New England Journal of Medicine, could point to new targets for drugs.
Experts said gene testing could not predict who would get the condition.
One in seven children in the UK suffers from asthma, which causes the airways to become irritated and narrow, making it harder for them to breathe.
The reasons why people develop the disease are not yet fully clear, although scientists suspect a roughly equal mixture of genetic susceptibility and environmental factors.
The latest genetic variants discovered by the international research appeared in more than a third of children with asthma.
However, the gene with the strongest impact on children did not affect people who developed asthma in adulthood, suggesting that the two versions of asthma may differ biologically.
Some of the genes identified are involved in the body’s system for telling the immune system about damage to the lining of the airways, while others appear to control how quickly the airways heal.
Scientists have identified seven genes linked to childhood asthma that paves the way for new treatments.
The biggest study of its kind, led by British researchers, picked out new targets for drugs or antibody agents that could be developed within ten years.
The international study looking at DNA from more than 26,000 people found several genetic variants that substantially increase susceptibility to asthma in children.
Most importantly, the study appears to show that allergies are a ‘side effect’ of asthma, rather than causing the condition.
Childhood asthma, which affects boys more than girls and can persist throughout life, is often linked to allergies, and it has been assumed these can trigger it.
The findings, published yesterday in the New England Journal of Medicine, were led by researchers from Imperial College London.
Professor William Cookson, Director of Respiratory Sciences at Imperial College London, who co-ordinated the study, said allergies seem to produce an extra layer of symptoms in people prone to asthma, instead of being a trigger.
‘About 60 per cent of people with asthma suffer from some form of allergy; there has always been a close relationship.
‘It has always been assumed that allergies are driving the process and that is where the focus of research has been, without too much success,’ he said.
Prof Cookson said scientists now had the opportunity to target seven ‘accessible’ genetic variants which should yield results in the near future.
He said: ‘One of the problems with asthma research has been choosing where to intervene in the disease pathways.
‘Our study now highlights targets for effective asthma therapies, and suggests that therapies against these targets will be of use to large numbers of asthmatics.
‘I would hope to see treatments using antibodies or drugs against them within ten years; it’s quite feasible’ he added.
Researchers have reported that a drug commonly used for the treatment of chronic obstructive pulmonary disease (COPD) successfully treats adults whose asthma is not well-controlled on low doses of inhaled corticosteroids. The effort was supported by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
“This study’s results show that tiotropium bromide might provide an alternative to other asthma treatments, expanding options available to patients for controlling their asthma,” said NHLBI Acting Director Susan B. Shurin, M.D. “The goal in managing asthma is to prevent symptoms so patients can pursue activities to the fullest.”
According to the study, adding tiotropium bromide to low doses of inhaled corticosteroids is more effective at controlling asthma than doubling inhaled corticosteroids alone, and as effective as adding the long-acting beta agonist salmeterol. The results were published online today in the New England Journal of Medicine and presented at the Annual Congress of the European Respiratory Society in Barcelona, Spain.
Increasing inhaled corticosteroids or supplementing them with long-acting beta agonists like salmeterol are the two preferred treatment options available for adults whose asthma is poorly controlled on low doses of inhaled corticosteroids. However, higher doses of corticosteroids do not improve symptoms for all patients and can have significant side effects, while long-acting beta agonists have come under scrutiny for their risk of worsening asthma symptoms that could result in hospitalization and, rarely, death.
Adding Spiriva to conventional therapy improves symptoms in patients whose asthma is poorly controlled and gives them more days without breathing problems, researchers reported on Sunday.
Spiriva, co-marketed by Pfizer and the privately held Boehringer Ingelheim, is already used for chronic obstructive pulmonary disease and works by blocking the nerves that can tighten the muscles surrounding the airways to the lungs.
Some asthma patients need more than the low dose of the corticosteroids they are typically given to inhale, but doctors fear more aggressive treatment can have drawbacks, including making the asthma worse.
Seeking a better treatment, the researchers tested different regimens on 210 patients, all of whom continued inhaling a low dose of corticosteroids.
For 14 weeks they received a double dose of the steroid, during another 14-week stretch they added Spiriva, known generically as tiotropium, and for a third testing period they inhaled salmeterol, a drug known as a beta agonist that relaxes the muscles lining the breathing passages of the lungs.
Spiriva worked at least as well as salmeterol and better than doubling the steroid dose, according to the results, released online by the New England Journal of Medicine and at a meeting of the European Respiratory Society in Barcelona, Spain.
The common asthma drug albuterol can help patients with multiple sclerosis, perhaps by tamping down an overactive immune system, U.S. researchers reported on Monday.
The cheap pill, available generically, may enhance the effects of a standard MS treatment called glatiramer, the researchers reported in the Archives of Neurology.
The Multiple Sclerosis Association of America estimates that 350,000 to 400,000 Americans have MS, which has no cure. Treatments are often expensive so insurers and patients would welcome cheap, generic drugs that can help the disease, which most frequently affects young adults.
Dr. Samia Khoury of Brigham and Women’s Hospital and Harvard Medical School in Boston and colleagues tested 39 patients with relapsing-remitting MS, a form of the disease that has an uncertain progression.
Patients got injections of glatiramer, an MS drug sold under the brand name Copaxone by Teva Pharmaceutical Industries Ltd.
Half got a placebo pill and half got albuterol, sold in Europe under the name salbutamol.
The patients were followed and examined for a year, with tests of their blood, and scans of their brains.
Few patients had relapses. But those who got both drugs had 0.09 relapses over the year on average, while those that got a placebo had a relapse rate of 0.37 per year, the researchers found.
http://www.reuters.com/article/idUSTRE68C4IL20100913
This cohort study has found an association between reports of asthma and later development of prostate cancer. It is difficult to interpret some of the findings, and the researchers acknowledge that it is difficult to unpick the effects of asthma medications from the asthma diagnosis itself.
All cohort studies have a potential weakness in that they cannot control for all confounding factors that may potentially influence the relationship being studied. While this research took into account some factors, including age, alcohol, smoking, it did not adjust for other known risk factors including family history of disease and physical activity. It is not clear what effects these would have had on the results.
The authors raise another limitation of their study in that their questions did not distinguish between ‘types of asthma’ and whether there were co-existing allergies.Adding to this, participants were asked if a doctor had ever told them that they had asthma or ‘wheezy breathing’, meaning it is highly possible that many men responding to this latter question were categorised as having asthma when they actually did not. Wheeze can be caused by many things, including acute respiratory infections and also chronic bronchitis.
A further problem arises due to the overlap between the medications used in asthma and in bronchitis (both of which can be treated with bronchodilators and steroids), which may have led to some people being wrongly considered as asthmatic. However, there are some strengths, too: notably, the prospective design and the large sample.
The strongest associations noted were with oral (systemic) glucocorticoids, although the researchers highlight that “it is premature to propose that use of systemic glucocorticoids are responsible for the observed associations” with prostate cancer. Instead, they say the drugs may suppress the immune system and therefore increase the risk of the disease.
This research may inspire further study into the association between asthma and risk of cancer, but the bottom line is that there is no evidence from this study that using asthma medication increases the risk of prostate cancer in people with asthma.