Men’s Health News

New Zealand’s Director-General of Health, Stephen McKernan, is warning people about the potential health dangers associated with three products promoted and sold in New Zealand for sexual enhancement or the treatment of erectile dysfunction which may contain an undeclared therapeutic substance.

This statement about the three products is being issued by the Director-General under Section 98 of the Medicines Act 1981, following investigations by the Ministry of Health’s medicines safety arm, Medsafe.

The products are Rize 2 the Occasion (also known as Rize 2), Rose 4 Her and Viapro. The products appear to have been sold by retail from ‘adult’ shops and over the internet.

The United States FDA has issued a warning that products on the US market with these names had been tested and recalled after they were found to contain the substance thiomethisosildenafil which is an analogue of sildenafil. Thiomethisosildenafil is expected to have similar therapeutic actions and adverse effects as sildenafil the active ingredient of the prescription medicine Viagra. Sildenafil is known to interfere with some heart medications and its use could be fatal to some individuals.

“Consumers should immediately stop taking Rize 2 the Occasion, Rose 4 Her and Viapro and seek medical advice from their doctor if they are taking other medicines or if they have felt unwell when taking any of these products,” said Mr McKernan.

Stephen McKernan also warned that Medsafe has previously identified a number of other products being sold in shops and over the internet to treat erectile dysfunction or for sexual enhancement that have also been adulterated with prescription medicines. Consumers should treat erectile dysfunction products offered for sale without a prescription with caution and seek medical advice before using them.

Under the medicines legislation, sponsors, distributors and importers are responsible for the products they sell and must be aware of all the active ingredients they contain and seek approval prior to selling them if required by the legislation.

http://www.moh.govt.nz/

Government and global health agencies have failed to adequately address the HIV/AIDS epidemic among men who have sex with men, according to a report by the American Foundation for AIDS Research released Monday at the XVII International AIDS Conference in Mexico City, Reuters reports. Although the disease has come to affect women and children as well, the researchers said MSM — the demographic originally most at risk of HIV/AIDS — remains at highest risk of infection. According to the report, research has found that MSM are 19 times more likely to be living with HIV than the general population, yet they are ignored in many countries.

Based on data from 128 countries submitted to UNAIDS, the report also found that 44% of countries failed to provide any data on MSM. According to the report, despite a unanimous commitment that all United Nations member countries made in 2001 to monitor HIV among high-risk groups, 71% of countries said they did not have any information on the percentage of MSM contacted by HIV prevention groups. According to the report, Benin, Ghana, Jamaica, Kenya and Thailand are the countries with the highest reported HIV prevalence rates among MSM. Although data were scarce, the study found MSM were 33 times more likely to be living with HIV than the general population in Latin America, 18 times more likely in Asia and at least four times more likely in Africa.

AmfAR CEO Kevin Frost said the failure of the Global Fund To Fight AIDS, Tuberculosis and Malaria, the President’s Emergency Plan for AIDS Relief, the World Bank and other global health organizations to allocate “significant resources toward reducing HIV rates among MSM is indefensible.” Frost added, “These organizations have policies on women, drug users, migration — but not one of them has a comprehensive policy on MSM.” Joe Chan of AIDS Concern in Hong Kong said some new cases of HIV/AIDS among MSM were occurring even after they had undergone repeated HIV tests, and counseling. “These are clients who have undergone repeated tests and we find that they are still engaging in unsafe sexual behavior,” Chan said (Lyn, Reuters, 8/5).

The report is available online (.pdf).

Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Men’s Health News

The latest information regarding the PSA (prostate-specific antigen) test for prostate cancer, is advising men age 75 and older not to be screened.

It also says younger men should discuss the benefits and harms of the PSA test with their doctors before being tested.

The new recommendation comes from the U.S. Preventive Services Task Force which has found evidence that screening for prostate cancer provided few health benefits but led to substantial physical and some psychological harm in men age 75 and older.

The Task Force says for men younger than 75, the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening.

Prostate cancer is the most common type of cancer that afflicts Australian men and the second highest cause of cancer deaths in men.

Screening for prostate cancer is most often performed using PSA tests and digital rectal exams and while the PSA test is more likely to detect prostate cancer than the digital rectal exam, prostate cancers that are found with a PSA test take years to affect the health.

Most prostate cancers that grow serious enough to cause death take more than 10 years to do so and the researchers say as a 75-year-old man has an average life expectancy of about 10 years he is more likely to die from other causes such as heart disease or stroke, and prostate cancer screening is unlikely to help men over 75 live longer.

Men younger than 75 with chronic medical problems and a life expectancy of fewer than 10 years are also unlikely to benefit from screening.

The researchers say prostate cancer screening, may include biopsies, unnecessary treatment and false-positive results that may lead to anxiety and complications often result from treating prostate cancer which can manifest as urinary incontinence and impotence.

The researchers say that slow-growing prostrate cancers may never affect a patient’s health or well-being had they not been detected by screening and in many cases early detection may may even cause harm.

The researchers men younger than 75 should discuss with their doctor the potential but uncertain benefits and the possible harms of getting the PSA test before they are screened.

This research is the first by any group to define an explicit age cutoff above which screening is likely to be ineffective or harmful and should help to clarify the potential benefits of screening in men under the age of 75.

The Task Force recommendations and accompanying evidence appear in the current issue of the Annals of Internal Medicine.

Men’s Health News

Quality of care varies greatly for the treatment of men with early-stage prostate cancer by region of the country and category of health care facility, suggesting the potential for improved patient outcomes with more standard treatment protocols, according to a new study that was published in the Aug. 1 issue of the Journal of Clinical Oncology (2008: Vol. 26, Issue 22).

The inconsistencies in care also suggest that there is much to do before quality improvement initiatives, such as pay-for-performance, can be instituted nationwide, according to Benjamin A. Spencer, M.D., M.P.H., the lead author of the study. Dr. Spencer is a urologic oncologist at NewYork-Presbyterian Hospital/Columbia University Medical Center and an assistant professor of urology at the Columbia University College of Physicians and Surgeons.

“We found significant variations for early-stage prostate cancer quality indicators. There were differences in care from community hospitals to cancer centers to teaching hospitals. There were also disparities in care from one region of the country to another. But there were no racial disparities, suggesting equity in care once a patient initiates treatment,” says Dr. Spencer. “If these variations in care can be eliminated, thereby providing uniform quality, it may lead to improved outcomes for patients.”

The study reviewed national databases and individual patient charts to identify gaps in care for prostate cancer using comprehensive quality measures developed by RAND.

All therapies for localized prostate cancer can significantly impact the patient’s quality of life. Improving the quality of care throughout the health care system could greatly improve quality-of-life issues for men treated for the disease.

Compliance with structural measures, such as having more than one board-certified urologist and board-certified radiation oncologist on staff, was high at near or greater than 90 percent. In contrast, compliance with standards for pre-therapy assessments of sexual and bowel function was low, at less than 52 percent.

Comprehensive cancer centers and teaching/research hospitals had higher compliance rates than community cancer centers across the board on nearly all compliance measures. Compliance rates varied greatly throughout the country on several measures, including board-certified urologists and radiation oncologists, communication with primary care physician and conformal total radiation dose.

High-quality care is possible, as evidenced by the near or greater than 80 percent compliance with pre-therapy disease severity assessment and counseling indicators. However, compliance was substantially lower for pre-therapy functional assessment and post-treatment follow-up indicators.

Using the National Cancer Data Base, the study sampled early-state prostate cancer cases diagnosed in 2000 through 2001 and explicitly reviewed medical records from 2,775 men treated with radical prostatectomy or external-beam radiation therapy. The researchers determined compliance with 29 quality-of-care disease-specific structure and process indicators developed by RAND, stratified by race, geographic region and hospital type.

http://www.nyp.org/

Men’s Health News

Researchers at the University of Adelaide have developed a novel approach to treating advanced prostate cancer that could be more effective with fewer side effects.

Professor Wayne Tilley and Dr Lisa Butler of the University’s Dame Roma Mitchell Cancer Research Laboratories have discovered that by using existing prostate cancer drugs in combination with new drugs at lower doses, they can expect to generate better results for patients than current treatments.

Growth of prostate cancer is initially dependent on hormones called androgens, which traditionally have been suppressed to stop tumour growth. However, despite an initial response, resistance to hormone deprivation often occurs and the tumour starts to grow again, Professor Tilley says.

“Men undergoing hormone deprivation therapy can also experience significant side effects, including reduced libido, impotence, hot flushes, tiredness and sweating, gradual decrease in body hair, reduced bone and muscle strength and cognitive changes,” he adds.

Professor Tilley and Dr Butler have successfully killed prostate cancer cells in laboratory studies using low doses of a combination therapy of drugs including bicalutamide (an anti-androgen that opposes the action of androgen on the tumour), and the inhibitors 17AAG and vorinostat.

These new drugs block key cancer survival pathways, but are not particularly effective in killing prostate cancer cells if given alone.

“We can now confirm that a very low level of bicalutamide is capable of inhibiting cancer cell proliferation by more than 10-fold when combined with either vorinostat or 17AAG, making our current treatments much more effective and causing fewer side effects,” says Dr Lisa Butler.

All the drugs needed for combination therapy are already approved for use in clinical trials, so the new therapy can be readily tested in patients with advanced prostate cancer.

Professor Chris Sweeney, a world recognised medical oncologist and Director of Clinical Trials at the Royal Adelaide Hospital Cancer Centre, will lead a multidisciplinary team to test the new treatment.

“The ultimate test of this exciting laboratory breakthrough is to see if it improves outcomes and quality of life for men suffering from advanced prostate cancer,” he says.

“The strong partnership between medical scientists and clinicians at the University of Adelaide and the Royal Adelaide Hospital means patients can benefit from advances in medical science much faster than in the past.”

Professor Tilley is a founding member of the Freemasons Foundation Centre for Men’s Health, which is working towards establishing a national prostate cancer research facility in Adelaide.

http://www.adelaide.edu.au/

Men’s Health News

If you’re fishing for ways to reduce the risk of heart disease, you might start with the seafood-rich diet typically served up in Japan. According to new research, a lifetime of eating tuna, sardines, salmon and other fish appears to protect Japanese men against clogged arteries, despite other cardiovascular risk factors.

The research, published in the August 5, 2008, issue of Journal of the American College of Cardiology (JACC), suggests that the protection comes from omega-3 fatty acids found in abundance in oily fish. In the first international study of its kind, researchers found that compared to middle-aged white men or Japanese-American men living in the United States, Japanese men living in Japan had twice the blood levels of omega-3 fatty acids-a finding that was independently linked to low levels of atherosclerosis.

“The death rate from coronary heart disease in Japan has always been puzzlingly low,” said Akira Sekikawa, M.D., Ph.D, an assistant professor of epidemiology at the University of Pittsburgh, PA, and an adjunct associate professor at Shiga University of Medical Science, Otsu, Japan. “Our study suggests that the very low rates of coronary heart disease among Japanese living in Japan may be due to their lifelong high consumption of fish.”

Japanese people eat about 3 ounces of fish daily, on average, while typical Americans eat fish perhaps twice a week. Nutritional studies show that the intake of omega-3 fatty acids from fish averages 1.3 grams per day in Japan, as compared to 0.2 grams per day in the United States.

Earlier studies by Dr. Sekikawa’s team showed that Japanese men had significantly less cholesterol build-up in their arteries when compared to white men living in the United States-despite similar blood cholesterol and blood pressure readings, similar rates of diabetes and much higher rates of cigarette smoking. It was unclear, however, whether Japanese men were protected by strong genes, a high-fish diet or some other factor.

To answer that question, the ERA JUMP (Electron-Beam Tomography, Risk Factor Assessment Among Japanese and U.S. Men in the Post-World War II Birth Cohort) Study enrolled 868 randomly selected men aged 40 to 49. Of these, 281 were Japanese men from Kusatsu, Shiga, Japan; 306 were white men from Allegheny County, Pennsylvania; and 281 were third- or fourth-generation Japanese-American men from Honolulu, Hawaii.

All study participants had a physical examination, completed a lifestyle questionnaire, and had standard blood tests to evaluate cardiovascular health. Laboratory tests also measured total blood levels of fatty acids and the omega-3 fatty acids that come from fish (specifically, eicosapentaenoic, docosahexaenoic and docosapentaenoic acids).

In addition, researchers used two techniques to measure the level of cholesterol build-up in the arteries. In the first test, ultrasound waves gauged the thickness of the walls of the carotid arteries in the neck, a test known as intimal-medial thickness (IMT). In the second test, an electron-beam CT scanner measured calcium deposits, or “hardened” cholesterol, in the arteries of the heart, a test known as coronary artery calcification (CAC). Both have been shown to identify people at high risk for heart disease.

Dr. Sekikawa and his colleagues found that the total level of fatty acids was similar in the three groups, but the percentage represented by fish-based omega-3 fatty acids was two-fold higher in Japanese men living in Japan (9.2 percent) when compared to white men (3.9 percent) and Japanese-American men (4.8 percent) living in the United States.

The researchers also found that levels of atherosclerosis were similar in Japanese-American and white men, but markedly lower in Japanese men living in Japan. The average IMT was 37 µm less in Japanese than white men after age and cardiovascular risk factors were taken into account, while the average risk-adjusted difference in the proportion of Japanese and white men with positive CAC tests was 11 percent. Both gaps were highly significant, but became statistically insignificant when differences in omega-3 fatty acid levels were taken into account.

In Japanese men living in Japan the investigators also observed that IMT values went down as omega-3 fatty acid levels went up, an inverse relationship that was found to be statistically significant. This relationship between omega-3 fatty acid levels and IMT remained significant even after adjusting for traditional cardiovascular risk factors. (In Japanese men, CAC also went down as omega-3 fatty acid levels went up, but the relationship was not statistically significant.)

No significant inverse association between omega-3 fatty acid levels and atherosclerosis was observed in whites or Japanese-Americans once cardiovascular risk factors were accounted for.

“Our study clearly demonstrated that whites and Japanese-Americans have similar levels of atherosclerosis, which are much higher than in the Japanese in Japan,” Dr. Sekikawa said. “This indicates that much lower death rates from coronary heart disease in the Japanese in Japan is very unlikely due to genetic factors.”

The importance of the fish-derived omega-3 fatty acids in reducing risk for heart disease is powerfully underscored by this cross-cultural study, said William S. Harris, Ph.D., senior scientist and director of the Metabolism and Nutrition Research Center, Sanford Research/University of South Dakota, Sioux Falls. “Japanese men in Japan have equally bad or worse cardiovascular risk profiles as Americans, but less heart disease? How can this be?” said Dr. Harris, who was not involved in the ERA JUMP study. “What really distinguishes the Japanese men from the Americans is the fact that blood levels of the omega-3 fatty acids are twice as high in Japan as they are in the West.

“The take home message from this important study is this: Traditional risk factors lead to traditional amounts of artery-clogging plaque but only when the background diet, perhaps the lifetime diet, is chronically deficient in omega-3 fatty acids. Increase the omega-3 intake and heart disease rates in the West should begin to move closer to those in Japan. While it may take a high omega-3 diet from birth (as opposed to popping a few fish oil pills) to reach this goal, Dr. Sekikawa and his colleagues tell a compelling story that we would do well to heed.”

A follow-up study has recently been funded and will test the association of omega-3 fatty acids with the progression of atherosclerosis in white men, Japanese-American men, and Japanese men living in Japan.

http://www.acc.org/

Men’s Health News

For the first time, a strategic plan for research into benign prostate disease, based on the latest scientific knowledge, has been published by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). The NIDDK Prostate Research Strategic Plan is the culmination of discussions and meetings among experts over the past two years in an effort to outline a strategic vision for research into these elusive and multi-faceted diseases.

“The NIDDK Prostate Research Strategic Plan reflects NIH?s commitment to advancing translational research by facilitating planning efforts among basic scientists, clinicians, advocacy groups, and patients,” said NIDDK Director Griffin P. Rodgers, M.D. “The educational summaries in each section of the plan provide clear explanations of the scientific data and the reasoning behind each of the recommended research priorities.”

The research area of benign prostate disease includes two of the most significant non-cancerous disorders affecting males - benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). BPH, an enlargement of the prostate gland, is often associated with lower urinary tract symptoms (LUTS). LUTS, which can include symptoms such as overactive bladder, restricted or excessive urination, and sensations of urgency, affects men of all races and ethnic groups and can become severe over time. An estimated 50 percent of men in their 50s have BPH and 26 to 46 percent of men between the ages of 40 and 79 have moderate to severe symptoms. CP/CPPS is generally described as inflammation of the prostate gland. There is no detectable bacterial basis, but CP/CPPS sometimes is associated with urinary symptoms, pain, and sexual dysfunction. The source of the pain in this syndrome is unknown and there are no generally effective methods for preventing or treating the condition.

The NIDDK Prostate Research Strategic Plan addresses the four major research areas judged critical for advancing the field. These include basic science, epidemiology and population-based studies, translational research, and clinical sciences. Recommendations from the plan include:

• Promote interdisciplinary research that focuses on how benign prostate diseases are influenced by other organ-specific diseases and systemic conditions, such as obesity, high blood pressure, high cholesterol, cardiovascular disease, diabetes, and erectile dysfunction. For example, the possible influence of high blood pressure on BPH/LUTS is a previously unexplored area of research.
• Study the primary prevention of benign prostate diseases, including possible benefits of lifestyle changes such as avoidance of alcohol and caffeine, frequency of sexual practice, pelvic massage therapy, stress reduction, and diet modulation for relief of CP/CPPS.
• Develop data and human tissue resources from patients of various ages to derive information useful in investigating risk factors, underlying causes and natural history of disease progression, quality of life, quality of care, and decision making regarding treatment of benign prostate disease. Develop imaging approaches and other biomarker studies to assess severity and risk of progression based on physical and cellular findings.
• Develop targeted medical therapies based on new insights into disease-relevant cellular pathways and physiological events.
• Develop standardized, clinically significant benign prostate disease syndrome definitions and classifications based on measurable phenotypic features.
• Train and mentor epidemiologists, health services researchers, clinical investigators, and students interested in the study of benign prostate disease.

“The long-standing, unanswered questions about the causes of these disorders prompted the NIDDK to examine the state of the science and to develop a new vision for future research,” explained Chris Mullins, Ph.D., NIDDK?s director of basic cell biology programs in urologic and kidney disease. “As part of this process we convened the Prostate Research Planning Committee, composed of clinical and basic scientists and epidemiologists from around the country, to review and evaluate past and current research and to make individual recommendations for new research priorities. The NIDDK Prostate Research Strategic Plan is the result of that collaborative effort.”

The plan is designed to be read by a broad audience of researchers, clinicians, advocacy groups, representatives of funding organizations, and patients. Each major section includes a mission statement, a lay summary, an overview of current knowledge, and high-priority recommendations for future research. The plan is online at http://www2.niddk.nih.gov/NR/rdonlyres/318606D2-A9D1-4CAD-B9BF-8EB3009C83BE/0/NIDDKProstateStrategicPlan.pdf and can be purchased online in print or compact disc format at http://catalog.niddk.nih.gov/PubType.cfm?Type=182&CH=NKUDIC.

NIDDK conducts and supports research in diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic, and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans.

http://www.niddk.nih.gov.

Men’s Health News

Scientists say a new drug which treats aggressive prostate cancer is possibly the most significant development in the field for 70 years.

The new drug Abiraterone could they say potentially treat up to 80% of patients with a deadly form of the disease which is resistant to currently available chemotherapy.

Abiraterone works by blocking the hormones which fuel the cancer and is a major step forward in the treatment of end-stage prostate cancer patients.

Prostate cancer is the most common cancer among men and each year, 680,000 men worldwide are diagnosed with the disease and about 220,000 will die from it.

On the assumption that the cancer was driven by sex hormones such as testosterone produced in the testicles, current treatments aim to stop the testicles from producing testosterone.

Now experts have discovered that the cancer can feed on sex hormones from all sources, including supplies of the hormone produced by the tumour itself.

Abiraterone targets an enzyme called CYP17, which plays a key role in this process and works by blocking production of the hormones throughout the body.

An advanced clinical trial involving 1,200 patients around the world is currently under way, with more trials likely later this year.

The latest study is based on just 21 patients with advanced, aggressive prostate cancer who were treated with a ‘once-a-day’ pill.

The study found significant tumour shrinkage, and a drop in tell-tale levels of a key protein produced by the cancer called prostate specific antigen in the majority of patients.

Many of the patients, who have been monitored for up to two-and-a-half years, have reported a significant improvement in the quality of their lives and some were able to stop taking morphine for the relief of pain caused by the spread of the disease to their bones.

Lead researcher Dr. Johann de Bono from the Institute of Cancer Research says while the findings need to be confirmed in larger trials, they believe a major step forward in the treatment of end-stage prostate cancer patients has been made.

Dr. de Bono says men with very aggressive prostate cancer are exceptionally difficult to treat and the disease is almost always fatal.

He hopes that abiraterone will eventually offer them real hope of an effective way of managing their condition and prolonging their lives and that the drug will also help other cancer patients, including those with breast cancer.

Experts say the results are promising but are still at the early stages of clinical development and it will be crucial to carefully examine the balance between its benefits and harms, before reaching a firm conclusion about the new drug.

The researchers say some of the volunteers have been on the drug for as long as two-and-a-half years and were able to control the disease with few side effects.

The drug is now in Phase III trials and Dr. de Bono hopes to have it on the market in 2011.

The research is published in the Journal of Clinical Oncology.

Men’s Health News

The veteran radio broadcaster Alan Jones has reportedly had successful surgery for prostate cancer.

Jones, age 67 was first diagnosed with prostate cancer in May following a biopsy but kept his condition a close secret until earlier this month.

A spokesman for Sydney’s St Vincent’s Hospital says no details will be released about his condition but reports from family members indicate the operation was successful and surgeon Professor Phillip Stricker was apparently happy with the result.

Jones is said to be comfortable and resting and receiving visitors and is expected to remain in hospital until the middle of the week.

Alan Jones approached the surgery with a positive attitude and is expected to make a full recovery.

He has been a champion in advocating regular prostate cancer check ups for men warning the “invisible” disease can be terminal by the time symptoms appear.

He is expected to be back on the air in two to three weeks.

World Cup legend Sir Geoff Hurst, MBE, backed by leading doctors, MPs and patient groups today appealed for all men with prostate cancer to get access to the best care as it emerged 7 out of 10 with advanced disease do not receive chemotherapy despite being eligible for treatment.1 Senior cancer specialists warned that while some men may have been offered chemotherapy and turned it down, others may never have been given the option at all, and so many patients are currently not being offered the full choice of treatments that could extend their lives.

The new ‘7 out of 10′ campaign, which is calling for all men with prostate cancer to be made fully aware of their options, was launched today by England football hero Sir Geoff Hurst MBE by the Houses of Parliament in London. To illustrate the ‘7 out of 10′ statistic, he was joined by 10 men, including seven dressed only in underwear bearing the campaign’s distinctive dice logo and the slogan “Access to prostate cancer care shouldn’t be left to chance”.

An early day motion supporting the ‘7 out of 10′ campaign, sponsored by Howard Stoate MP, chairman of the All Party Parliamentary Group on Men’s Health, has been laid down in Parliament which MPs are being urged to sign. Members of the House of Commons and House of Lords are also being encouraged to ask Parliamentary questions and write to their NHS Trust about whether patients are being offered all treatment options, including chemotherapy, in line with NICE guidelines.

Around 35,000 men are diagnosed with prostate cancer every year2 making it the most commonly diagnosed cancer in men in the UK.3 It kills around 10,000 men every year, or 27 every day, placing it second only to lung cancer as the most common cancer killer of men. 4

Launching the new campaign, Sir Geoff Hurst, MBE, whose hat trick famously won the 1966 World Cup Final for England, said: “Like any footballer, luck as well as skill has played a part in my success. There are some who would argue that were it not for a fortunate decision by the linesman on my second goal in the final in 1966, England might not have gone on to win the World Cup. However when it comes to your health, none of us want to take any chances and so that is why I am backing this campaign. It is important that men with this disease, which is the most common cancer in British men, know all their options so they can make informed decisions and get the best possible care they can.”

Metastatic hormone refractory prostate cancer (mHRPC) is an advanced stage of the disease at which the tumour initially stops responding to hormone therapy. There are a range of treatment options for patients at this stage of the disease including bone-targeted therapies, radiotherapy and chemotherapy.5

Of the 10,000 men who die from prostate cancer each year4 it is believed most are in men with mHRPC6. It is estimated that almost half may have been fit enough to receive chemotherapy1, yet only 1,421 patients actually received chemotherapy in 20071, leaving seven in 10 who missed out on this treatment option.1

John Anderson, consultant urologist at Sheffield Teaching Hospitals, said: “There are major differences across the country which means many men with advanced prostate cancer patients are not being offered the full range of treatments. Access to prostate cancer care should not be left to chance. We need to encourage better shared care across the country and for medical teams to work more closely together, so all patients are fully aware of their options.”

Dr Amit Bahl, Consultant Oncologist at Bristol Haematology and Oncology Centre, said: “Chemotherapy is a relatively new treatment option for men with this form of prostate cancer and needs to be considered at the right time to be able to benefit men. Healthcare teams should discuss all potential treatments with men as early as possible, so patients can consider their options and make the best choice for them at every stage of their care.”

Dr Heather Payne, Consultant Oncologist, London and Chair of the British Uro-oncology Group (BUG) said; “These findings are consistent with initial research work into the management of advanced prostate cancer, initiated by BUG in 2007.7 This research suggests that around 30% of oncologists would choose to recommend chemotherapy as indicated in the clinical setting and a rapidly rising PSA. 7 Whilst the use of chemotherapy for the treatment of advanced metastatic hormone refractory prostate cancer is recommended by NICE and we have seen an increase in its usage over the past year, there is a significant way to go before all eligible men benefit from the timely intervention of the appropriate treatments.”

The National Institute for Health and Clinical Excellence (NICE) said in 2002 that all patients with urological cancers should be managed by multi-disciplinary urological cancer teams.8However in its Prostate Cancer Guideline this year the Institute stated that its earlier recommendations were not being universally implemented5 and its Guideline Development Group stated that the management of men who develop biochemical evidence of hormone refractory disease was not usually discussed at MDT meetings, despite NICE’s 2002 recommendations.5

The ‘7 out of 10′ campaign, which is being sponsored by sanofi-aventis, aims to ensure that all prostate cancer patients and their carers are made aware as early as possible of all potential treatment options and are empowered to make informed choices about the management of their disease. It also aims to drive the multi-disciplinary approach to the management of prostate cancer patients and to foster communication between urology and oncology teams as recommended by NICE, to ensure that all treatment options are fully explored with the patient.

About the 7 out of 10 figure

The figure was based on research1by sanofi-aventis, a leading pharmaceutical company with a strong portfolio in oncology, and validated by 10 clinical experts at two advisory meetings held in 2008.9 This figure may well include patients who have been offered chemotherapy and turned it down, but also those who have not been given the option or have had inadequate information to make an informed choice.

About sanofi-aventis

Sanofi-aventis, a leading global pharmaceutical company, discovers, develops and distributes therapeutic solutions to improve the lives of everyone. Sanofi-aventis is listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY). http://www.sanofi-aventis.com

Forward Looking Statements

This press release contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, as amended. Forward-looking statements are statements that are not historical facts. These statements include product development, product potential projections and estimates and their underlying assumptions, statements regarding plans, objectives, intentions and expectations with respect to future events, operations, products and services, and statements regarding future performance. Forward-looking statements are generally identified by the words “expects,” “anticipates,” “believes,” “intends,” “estimates,” “plans” and similar expressions. Although sanofi-aventis’ management believes that the expectations reflected in such forward-looking statements are reasonable, investors are cautioned that forward-looking information and statements are subject to various risks and uncertainties, many of which are difficult to predict and generally beyond the control of sanofi-aventis, that could cause actual results and developments to differ materially from those expressed in, or implied or projected by, the forward-looking information and statements. These risks and uncertainties include among other things, the uncertainties inherent in research and development, future clinical data and analysis, including post marketing, decisions by regulatory authorities, such as the FDA or the EMEA, regarding whether and when to approve any drug, device or biological application that may be filed for any such product candidates as well as their decisions regarding labelling and other matters that could affect the availability or commercial potential of such products candidates, the absence of guarantee that the products candidates if approved will be commercially successful, the future approval and commercial success of therapeutic alternatives as well as those discussed or identified in the public filings with the SEC and the AMF made by sanofi-aventis, including those listed under “Risk Factors” and “Cautionary Statement Regarding Forward-Looking Statements” in sanofi-aventis’ annual report on Form 20-F for the year ended 31 December 2007. Other than as required by applicable law, sanofi-aventis does not undertake any obligation to update or revise any forward-looking information or statements.

References

1. Data on file: 710 08/1180

2. Cancer Research UK. CancerStats Key Facts on Prostate Cancer. Available here. [last accessed 19 June 2008]

3. Cancer Research UK website. Available here. [last accessed 12 June 2008]

4. Cancer Research UK. Available here. [last accessed 12 June 2008]

5. National Institute for Health and Clinical Excellence (NICE). Prostate cancer: diagnosis and treatment: Clinical Guideline 58, February 2008. Available here. [last accessed June 12 2008]

6. National Institute for Health and Clinical Excellence (NICE). Docetaxel for the treatment of hormone-refractory metastatic prostate cancer. 2007 Available here. [last accessed June 12 2008]

7. British Uro-oncology Group presentation “Call for Your Points of View on Advanced Prostate Cancer” 2007

8. National Institute for Health and Clinical Excellence (NICE). Guideline on Improving outcomes in Urological Cancers. Available here. [ last accessed 20 June 2008]

9. Data on file: 710 08/1084

Sanofi-Aventis