Karen Gierszewski and Sean Messenger
At the recent meeting of the Society of Interventional Radiology (SIR) in San Francisco, a potential new indication for embolization was unveiled. Early research shows that benign prostatic hyperplasia (BPH), an unpleasant condition involving the noncancerous enlargement of the prostate, may be able to be treated effectively with embolization
. In fact, according to the study presented at the SIR meeting in March
, the treatment—known as prostatic artery embolization (PAE)—is associated with few serious side effects and may reduce prostate size by more than 30%.
These findings are exciting for two main reasons. First and foremost, for men suffering from BPH who have not responded to drug treatments and who are not candidates for transurethral resection of the prostate, PAE offers a minimally invasive option that may not be associated with all of the side effects of surgery, such as impotence or urinary incontinence. Given that BPH affects approximately 50% of men by age 60 and more than 90% of men by age 85
, the number of men that could potentially benefit from this treatment is huge. Second, for companies in the embolization particle market, this indication might finally be the breakthrough they needed. Although historically these companies have been focusing on pushing embolization as a treatment for uterine fibroids, this area has not proven to be as fruitful as everyone hoped because gynecologists have typically been unwilling to refer patients to an interventional radiologist for embolization when they could perform a more profitable hysterectomy or myomectomy in-house. There has also been some interest in liver cancer as an indication; however, this space has been pretty competitive, especially since the introduction of radioembolization spheres and drug-eluting beads. As a result, BPH might represent the most lucrative growth opportunity for embolization particle manufacturers such as CeloNova Biosciences, BioSphere Medical (owned by Merit Medical Systems), and Biocompatibles (owned by BTG International).
Industry sources are, however, quick to point out that research in this area is still in its early stages and that much more clinical evidence is needed before widespread adoption occurs. Also, we have to question whether urologists will be any more willing to refer patients to interventional radiologists than their gynecologist colleagues. Nonetheless, embolization particle companies will be closely following events in this area as they unfold.