BPH patients and the placebo effect
Question: Why are BPH patients particularly prone to the placebo effect?
Answer: It’s not only benign prostatic hyperplasia (BPH) patients. This is seen with many chronic benign disorders, for example asthma or incontinence. When you first see the patient, they are always worried that it could be something more serious. The patient is reassured by the doctor, and just the fact that they are being checked by a health professional brings some subjective improvement because it alleviates stress and anxiety, which can make any symptom seem worse. The other factor is that if you don’t treat BPH at all, the disease fluctuates naturally — there are good and bad periods, but over the long term it has an overall worsening. It never gets better all by itself. The patient always goes to the doctor when the symptoms are at their worst, and if you have a seasonal variation, whatever you do over the next two or three months the symptoms will seem to improve because of the natural cycle. That’s why we had a two-year trial, to try to eliminate the possible bias caused by the natural fluctuation.