THIS STUDY evaluated four treatments -- with morphine, gabapentin, a combination of the two drugs or a placebo -- in 57 adults with nerve pain from diabetes (diabetic neuropathy) or shingles (postherpetic neuralgia). Participants took each treatment for five weeks, in random order; they did not know what they were taking at any given time. Participants reported the least pain when taking the morphine-gabapentin combination, though constipation was more frequent than with gabapentin alone, and dry mouth was more frequent than with morphine alone.
WHO MAY BE AFFECTED BY THESE FINDINGS? People with nerve pain, especially when derived from diabetes or shingles.
CAVEATS Findings were based on self-reporting by the participants. Pfizer provided the gabapentin (Neurontin) and Aventis provided the morphine (M-Eslon) used in the study. Two of the six authors have received fees from these companies.
BOTTOM LINE People with diabetic neuropathy or postherpetic neuralgia may want to talk with a doctor about treatment with a morphine-gabapentin combination.
FIND THIS STUDY March 31 issue of the New England Journal of Medicine; abstract available online at www.nejm.org.
LEARN MORE ABOUT postherpetic neuralgia at www.mayoclinic.comand diabetic neuropathy at diabetes.niddk.nih.gov.
Radiation therapy may increase the risk of rectal cancer.
THE QUESTION Using radiation to kill cancer cells has proved effective, but the therapy also has been connected, in some instances, to subsequent tumors. Might men who choose to treat prostate cancer with radiation be more likely to develop another type of cancer years later?
THIS STUDY analyzed data on 85,813 men who had been diagnosed with prostate cancer at least five years earlier and did not develop colorectal cancer within five years of the prostate cancer diagnosis. About 35 percent of the men had received radiation treatment; the others had had surgery to remove the cancer. After an average of nine years, 267 men had developed rectal cancer. Those who had undergone radiation were 70 percent more likely to develop this disease than were those who had surgery. Radiation did not seem to affect the rate of cancer in other parts of the body near the prostate.
WHO MAY BE AFFECTED BY THESE FINDINGS? Men with prostate cancer, which will affect an estimated one in every six men in the United States.
CAVEATS The authors indicated that overall rates of rectal cancer in both groups were low and suggested that prostate cancer treatments should not change based on these results. Estimates of time between radiation exposure and cancer are imprecise; cancer sometimes does not develop until 15 or more years after exposure.
BOTTOM LINE Men with prostate cancer should discuss possible implications of radiation with a doctor before deciding on a treatment method. Men who have had radiation for prostate cancer should be checked regularly for signs of rectal cancer.
FIND THIS STUDY April issue of Gastroenterology; abstract available online at www.gastrojournal.org (click "Articles in Press"; then search for "prostate").
LEARN MORE ABOUT treating prostate cancer at familydoctor.organd www.cancer.gov/cancertopics.
-- Linda Searing