ANNOUNCER: Funding for HealthWeek is provided by the Howard Heinz Endowment and the Teresa and H. John Heinz III Foundation.

SHARYL ATTKISSON: Today on HealthWeek... Does your nose know best when it comes to your health? Sniffing out the truth about aromas that are supposed to relax and heal.

An enlarged prostate: for many men, it can make it tough to enjoy their golden years.

AVON BEAN: "Well, the main problem I had was getting up several times a night to have to go to the bathroom."

SHARYL ATTKISSON: From herbs to microwaves, new strategies for treating enlarged prostates.

And a man who really knows what it takes when it comes to the nuts and bolts of rehabilitation.

HEART GENE

Hello. I'm Sharyl Attkisson. Welcome to HealthWeek.

Clogged arteries send millions of Americans to the operating room each year. When they occur around the heart, it can mean bypass surgery or balloon angioplasty. Clogs in the legs can lead to amputation. But a new era of treatment may be on the horizon.

In our Behind the Headlines segment we look at the latest on an experimental technique that's trying to help some patients grow new blood vessels. HealthWeek's Lauren Scott in Boston has details.

LAUREN SCOTT: For nearly a decade, Damian Ivanof battled leg problems caused by clogged arteries. And a year-and-half ago, doctors started talking amputation after numerous surgeries failed to restore blood flow.

DAMIAN IVANOF: I was almost saying go ahead and take the leg off because, I mean, the pain was just unbearable.

LAUREN SCOTT: But then, he came to Saint Elizabeth's hospital in Boston where researchers are testing a new type of treatment called gene therapy on people with blocked arteries.

The idea behind gene therapy is to get the body to make new blood vessels. This is done by injecting genes that stimulate new blood vessel growth near the blockage. Hopefully, new vessels develop there, and the patient grows their own bypass.

In a study published this week in the journal Circulation, researchers injected genes into the legs of nine patients, including Ivanof. The experimental treatment produced marked improvements in seven of them.

JEFFREY ISNER, MD, ST. ELIZABETH'S MEDICAL CENTER: We've certainly seen in a number of cases, patients who were referred because they were being considered for an amputation. And the growth of these new blood vessels has improved blood flow enough that they have been able to avoid undergoing an amputation.

LAUREN SCOTT: Since their initial study, the researchers have tested gene therapy on 20 more people with leg blockages. They've also tried it in three patients with blocked arteries near the heart. The hope is that it may some day give patients facing heart surgery another option. But it's still too soon to tell.

JEFFREY ISNER, MD: I think that gene therapy should not be viewed at this time as anything approaching an alternative to bypass surgery or angioplasty.

LAUREN SCOTT: But for Damian Ivanof, gene therapy appears to be living up to its billing. He can walk a half-mile a day without pain. And nobody's talking amputation anymore.

DAMIAN IVANOF: For me, it's almost a new life, thank God.

SHARYL ATTKISSON: Joining us now is Doctor Nelson Wivel, former head of the government panel that reviews gene therapy tests and deputy director of the University of Pennsylvania's Institute for Human Gene Therapy.

Doctor Wivel, as simple as you can, explain to us how the gene therapy works. Are these genes being injected into patients because they don't have them naturally?

NELSON WIVEL, MD, UNIV. OF PENNSYLVANIA: No, these are normal genes that everybody has.

SHARYL ATTKISSON: And so why is the need to inject them into a patient if the patient already has that gene?

NELSON WIVEL, MD: Well, normally this gene functions during the early development of the fetus. At that time, it is turned on; otherwise, it is turned off. What we've done is to engineer that gene so that it's turned on all the time and will grow new blood vessels for these patients.

SHARYL ATTKISSON: Whether researchers are using gene therapy or injecting proteins to make the blood vessels grow, what are some of the safety concerns associated with that procedure?

NELSON WIVEL, MD: Well, there are at least two principal safety concerns that we have to keep in mind. First, it's possible that a patient might have a very small cancer and that this growth factor would cause that cancer to grow. Secondly, there could be problems if new blood vessels sprouted in the retina of the eye, and this might impair vision.

SHARYL ATTKISSON: We have talked about one use for this type of gene therapy, but what are some of the other things on the horizon, other medical conditions that could possibly be treated this way?

NELSON WIVEL, MD: Of the current trials that are underway in this country, about 80 percent are devoted to the study of cancer, about 15 percent are directed toward genetic deficiency diseases, such as cystic fibrosis, and there are a number of trials that are used for the study of AIDS.

SHARYL ATTKISSON: And from a patient's standpoint, how successful has gene therapy been?

NELSON WIVEL, MD: Well, up to now, quite frankly, we do not have any unequivocal evidence of efficacy, but it's very early in the history of this technology, and there's every reason to assume that it will be important to medical treatment in the ensuing years.

SHARYL ATTKISSON: We will be watching. Thank you so much, Dr. Nelson Wivel.

NELSON WIVEL, MD: Thank you.

HEALTHFUL HINTS:

NANCY SNYDERMAN, MD: Hello, I'm Doctor Nancy Snyderman with this week's Healthful Hint.

We all know someone who's a "pain in the neck." But if you suffer from real-life neck pain, other people probably aren't to blame.

The main cause of neck pain is holding your head in an awkward position for too long. That can happen if you don't sit up straight, or if your work day requires you to look down all the time.

If that's the case, take frequent breaks, stand up or take a walk to give your neck a rest. Also, if you're on the computer a lot, make sure the screen is positioned correctly, right at eye level.

Strengthening your neck muscles can also help prevent pain. One simple exercise is to slowly turn your head from side to side as far as possible. Repeat that five times, twice a day. It might hurt a little bit at first, but in time, your neck will thank you for it!

With Healthful Hints, I'm Doctor Nancy Snyderman.

AROMATHERAPY:

SHARYL ATTKISSON: Many people seem to be rediscovering the sense of smell. You can get scented candles for your bedroom, perfumed oils for your bath water, sweet-smelling potpourri for the family room. And it doesn't stop there. Some think there's even a role for aromas when it comes to our health. HealthWeek's Andrew Holtz explains.

ANDREW HOLTZ: There's something in the air.

SHOPPER: "This smells very peachy."

ANDREW HOLTZ: It's the aroma of plant oils.

SHOPPER: "I like the smell of them. When there's lavender in them I automatically like them."

ANDREW HOLTZ: But at the Origins boutique in Manhattan, many are in search of fragrances that do more than smell good.

SHOPPER: "Like before you go to bed at night, it just kind of relaxes the whole environment."

ANDREW HOLTZ: "How does that work for you?"

SHOPPER: "I fall asleep right away."

ANDREW HOLTZ: Using these so-called "essential oils" to alter mood, or even more, is known as aromatherapy.

SHOPPER: "No, I've never heard of aromatherapy."

ANDREW HOLTZ: Origins prefers to call it "sensory therapy."

MARIA CORBISCELLO, ORIGINS: The products are therapeutic, versus just products that might be just nice to smell, and so everything that you smell in an Origins product has been put there for a reason, not just to smell good.

ANDREW HOLTZ: Jordan visits the Origins spa every week for an aromatherapy massage. She says it helps receive the stress of her work as creative director for the Motown Cafe chain.

Traci found her first massage at Origins was not like others she'd had.

TRACI JORDAN: "Yeah, this feels good, this feels different, I feel more relaxed. There was something different about the therapy there."

ANDREW HOLTZ: The difference was the aromatherapy oil.

CHRIS TAN, MASSAGE THERAPIST: Traci would like to reduce some stress, so I chose the stress reduction oil, which has a blend of vetiver, essential oil, lavender, and I think some cinnamon in it.

ANDREW HOLTZ: There is research that attempts to document the effects that aromas can have on mood, whether it's to stimulate or relax. However, there are people who think aromas have the power to do more than that: that aromatherapy may actually have the power to heal.

JERRI DEARBORN: And what I want to do with the aromatherapy is just use it in conjunction with what I'm already doing.

ANDREW HOLTZ: Aromatologist Eva Marie Lind is blending oils that Jerri Dearborn will add to her evening bath. Jerri turned to aromatherapy after conventional medical treatment failed to relieve her chronic pain.

JERRI DEARBORN: "Eva has blended some creams for me to rub into my body, and I noticed a great reduction in pain right away with that."

ANDREW HOLTZ: Lind had to be certified in Britain as an aromatologist because there is no licensing program in the United States.

She says her training and experience allow her to treat a variety of illnesses.

EVA MARIE LIND, AROMATOLOGIST: I've had a couple of HIV patients, I've had people with rheumatoid arthritis, fibromyalgia, it's chronic issues where they've tried everything.

ANDREW HOLTZ: Many aromatherapy patients swear by the power of essential oils, claiming they can help with everything from infections to depression.

Articles in aromatherapy journals spell out how to apply oils, along with theories of how they work. But you won't find aromatherapy in the journals of conventional medicine.

STEPHEN BARRETT, MD, QUACKWATCH INC: It's hype and fluff.

ANDREW HOLTZ: According to alternative medicine critic, Dr. Stephen Barrett, that's because there's no solid science to back up supporters' claims.

STEPHEN BARRETT, MD: If you like the aroma, you can use the product, but don't make the mistake of thinking that it's going to help your health; these products have nothing to do with health.

ANDREW HOLTZ: That's not to say essential oils get no notice from mainstream scientists. At the University of Wisconsin, researchers are studying whether an extract from the essential oil of lavender may be able to shrink advanced tumors.

HOWARD BAILEY, MD, UNIV. OF WISCONSIN HOSPITAL: Aromatherapy may or may not have potential in anti-cancer therapy. We pursued this because in the laboratory setting, and in animals with tumors, and now in people with cancer, it has shown that when people ingest it, take it orally, like pills, that it has good potential as an anti-cancer agent.

ANDREW HOLTZ: This study, and similar ones, are in their early stages.

Meanwhile, businesses aren't waiting for scientific studies.

"How much are the little..."

"They are $13.50."

"Oh, that is expensive."

ANDREW HOLTZ: To them, selling smells that soothe makes plenty of sense - and dollars.

SHARYL ATTKISSON: Well, whether or not you think aromas have any medical powers, nice fragrances can certainly make life more pleasant. But buying them at the store can be expensive. Maria Price of Willow Oak Herb Farm in Severn, Maryland shows how to make our own relaxing potpourri.

MARIA PRICE, WILLOW OAK FLOWER AND HERB FARM: A wonderful way to bring aromas into your life is by making potpourri. And I've chosen to make a dry potpourri that will give us a sedative or relaxing properties. And in it I've already put lavender and jasmine flowers and passion flower and chamomile and linden flower and hops, and I'm going to add fragrant rose petals that are the old-fashioned variety, that will help make us sleep a little better. And then to preserve the fragrance, I'm going to add

SHARYL ATTKISSON: If you'd like that and other recipes for potpourri, check out our site on the World Wide Web. To reach the HealthWeek home page, go to PBS ONLINE at the Internet address on your screen. That address is www.pbs.org.

BPH

Now, it's time for another HealthWeek quiz. This week we ask: Men with enlarged prostates are more likely to develop prostate cancer. True or False? The correct answer is false. An enlarged prostate does not put a man at greater risk of cancer. But it can put a serious crimp in his lifestyle. And chances are if a man lives long enough, his prostate will enlarge to a point where it may cause a problem. But that doesn't mean he has to put up with it. HealthWeek's Pat Anson reports on two of the newest treatments.

PAT ANSON: Meet two men who've suffered from BPH, benign prostatic hyperplasia, or an enlarged prostate.

Same disease, but two very different solutions.

CLAUS ROEHRBORN, MD: "I'll just make sure that our balloon in the bladder where it belongs.

PAT ANSON: One man went high tech, the other found relief in an herb. They're the latest approaches to deal with a common, aggravating problem for older men.

AVON BEAN: "Well, the main problem I had was getting up several times a night to have to go to the bathroom."

KEN HOBBS: "Sleep was virtually impossible. I'm a very light sleeper anyway. And I was up every hour, just about every hour."

PAT ANSON: BPH affects the prostate, a gland normally the size of a walnut that sits below the bladder.

Running through the center of the prostate is a tube called the urethra, which carries urine from the bladder out through

the penis. As men get older, cells within the prostate may grow more rapidly. If that happens, the gland enlarges and squeezes the urethra making it difficult to pass urine.

After age 60, over half of all men have some degree of BPH.

Often, the symptoms will go away on their own but severe cases can lead to bladder or kidney damage.

CLAUS ROEHRBORN, MD, UNIV OF TEXAS SOUTHWESTERN MED CENTER: If you ask me what makes the prostate grow, why does it grow in some men and why not in others? We do not have an answer.

PAT ANSON: When Avon Bean started having symptoms of BPH, and found himself running off the golf course in search of a bathroom, he decided to try something new. He became part of a clinical study where microwave therapy is used to shrink the prostate.

CLAUS ROEHRBORN, MD: The catheter is actually of course the heart and soul of the whole treatment.

PAT ANSON: Built inside this flexible catheter is a microwave antenna and a balloon. The catheter is inserted through the urethra all the way to the bladder.

CLAUS ROEHRBORN, MD: And when we inflate the catheter balloon at the mouth of the bladder, we know the antenna is right where we want it, in the middle of the prosthetic urethra.

PAT ANSON: The microwave is then activated heating the surrounding tissue to a temperature of nearly 175 degrees. The heat kills a portion of the prostate.

CLAUS ROEHRBORN, MD: The tissue will die and will eventually be absorbed and taken up by the body's white cells, the police in the body.

PAT ANSON: The prostate will be swollen and tender for about a month. But beyond that, the side effects are minimal.

AVON BEAN: I'm totally happy with the treatment I got. It's almost back to normal again. Not almost -- it is.

PAT ANSON: Some men are very uncomfortable with the idea of surgery or taking synthetic drugs to shrink the prostate. Many are turning to a more natural remedy to ease the symptoms of BPH.

After a drug gave him nausea and headaches, Ken Hobbs turned to his son, an herbalist for help.

Chris Hobbs recommended Saw Palmetto derived from berries that grow on a bushy palm.

Doctors in Europe have used Saw Palmetto for years to treat prostate problems.

CHRIS HOBBS: All the literature isn't in and all the studies haven't been done. But the bottom line is that it seems to help shrink the prostate and relieve symptoms when it's taken for a several month period.

PAT ANSON: Ken Hobbs started using Saw Palmetto 12 years ago. His symptoms have disappeared.

KEN HOBBS: My last visit to the doctor's office, he did an examination of the prostate gland and found it to be normal.

PAT ANSON: Saw Palmetto is catching on in the U.S. There are dozens of brands on the market. But its popularity brings the potential for problems. As an herb, Saw Palmetto is unregulated by the Food and Drug Administration.

PETER WALTHER, MD, SCRIPPS CLINIC, SAN DIEGO: There is no regulated quality control. I'm sure each company attempts to make the product as best they can. But when you subject these products to chemical analysis, you find that they are all different.

PAT ANSON: Doctor Peter Walther is doing research for a California company that wants the FDA to license its manufacturing process for Saw Palmetto.

PETER WALTHER, MD: Getting it licensed gives such great assurance that it's a reasonably safe compound.

PAT ANSON: Some doctors may need more convincing.

CLAUS ROEHRBORN, MD: I will not prescribe that and recommend it. There is no scientific rationale for it.

PAT ANSON: Whether it's herbs or drugs or surgery the important thing to men who suffer from BPH is whether it works.

Ken Hobbs has found his solution. So has Avon Bean.

Golf may still be a challenge, but it's a lot more enjoyable.

"Can you wait longer over a putt?"

AVON BEAN: "Oh, yeah, there's no question about that."

SHARYL ATTKISSON: Here to talk more about these and other treatments for BPH is Doctor Tom Jarrett, a urologist at Johns Hopkins Medical Institutions.

The microwave procedure sounds terrific. Are there any downsides to that?

TOM JARRETT, MD, JOHNS HOPKINS MEDICAL INSTITUTIONS: I think it's an exciting new therapy, but there are several definite downsides to it. Number one, it doesn't always work in the larger prostate glands. People have said that in these glands the effects are much more diminished compared to the smaller glands. Second of all, the effects may take two or three weeks to work, if they work at all, and then for some patients they may actually feel worse before they feel better.

SHARYL ATTKISSON: Are many doctors still opting to do traditional surgery to treat enlarged prostates?

TOM JARRETT, MD: That's a good question. There are several circumstances where a surgical procedure may be preferable to the lesser invasive surgeries, and those are patients who have recurrent urinary tract infections, if they've formed bladder stones, if they're having damage to their kidneys from the urine backing up, or if they're in retention of urine.

SHARYL ATTKISSON: Traditional surgery we know is very effective. Why are we looking for other routes?

TOM JARRETT, MD: Because even those open surgical, I mean surgical procedures are very effective, people would rather avoid the hospitalization and the risks of an open procedure. So I think it's best to try a lesser invasive modality if at all possible.

SHARYL ATTKISSON: Are there some patients that will be able to take simply prescription medicine as their course of treatment?

TOM JARRETT, MD: There are. There are two very good classes of drugs out there for treating the symptoms of BPH. The first class is called Alpha-Blockers. Commonly known ones are Hytrin, Cardura and Flomax. And a second class is called Proscar, which actually shrinks the prostate.

SHARYL ATTKISSON: Some men are simply told to really do nothing, to watch and wait and see how their symptoms change or whether they change at all. How do you know if a patient is somebody who should simply do nothing?

TOM JARRETT, MD: Well, I think patients with these symptoms should present to their doctor and let the doctor make the determination and go through the options with them. Many of the symptoms are more of an inconvenience rather than a health risk, and the doctor should be able to go through the options and help the patient make a decision.

SHARYL ATTKISSON: And briefly, in a word or two, any lifestyle changes for those men who decide to watch and wait?

TOM JARRETT, MD: There have been several factors that help with the symptoms of the prostate. Certainly stress relief has been a major contributor, diet, caffeinated products serve very bad for irritating the prostate, as are alcoholic beverages.

SHARYL ATTKISSON: Dr. Tom Jarrett, thanks for the information.

For more information on BPH or any other HealthWeek story, you can call our toll-free number shown at the end of the program.

DOCTOR'S CORNER:

BRUCE DAN, MD: I'm Dr. Bruce Dan.

At first glance, bodybuilders may not seem to suffer from problems of self-esteem. But even after pumping iron at the gym every day, some may actually see themselves as out of shape.

Recent studies in the journal Psychosomatics found that some bodybuilders are so obsessed with perfecting their physiques they quit jobs, shun friends and only go out to lift weights.

Oddly enough, these weight lifters hide their bodies in bulky clothes, complaining they look flabby. Sufferers with this body image disorder, dubbed "muscle dysmorphia," see a puffy body when they look in the mirror.

Doctors worry that bodybuilders with dysmorphia might start taking dangerous steroids to bulk up, ruining their health. To treat the condition, they suggest antidepressants.

Researchers obviously point out that just because people like to lift weights, doesn't automatically mean they have a psychological disorder. For most, it's a healthy and harmless pursuit.

With "Doctor's Corner," I'm Dr. Bruce Dan.

SHARYL ATTKISSON: Now, updates on a couple of recent stories that drew overwhelming response from our viewers: first a new treatment for impotence. The Food and Drug Administration has approved the first pill that can improve a man's ability to achieve and sustain an erection. The prescription medicine, called Viagra, should be available in a few weeks. It's expected to sell for $9.00 to $10.00 a pill, and already men are clamoring for it. But some experts are concerned it will be used inappropriately.

WILLIAM STEERS, MD, UNIV OF VIRGINIA MEDICAL CENTER: My fear is that it could be, you don't want like a Phen-Fen phenomenon where they're just pill clinics, where somebody comes in, "I have this problem," you write a prescription, and this will take care of it.

SHARYL ATTKISSON: And Viagra isn't the only such drug in the pipeline. Another expert we interviewed predicts a half-dozen more impotence pills will hit the market in the next seven years.

Meanwhile, an patch for women with urinary incontinence will be available without a prescription. The FDA this week approved over-the-counter sales of the UroMed Patch, which is pressed over the urinary opening to help reduce leakage. The disposable patches are expected to sell for less than a dollar each, and will probably be on store shelves by the end of the year.

HEALTHNOTE:

12% of people say they have trouble talking to a doctor about incontinence.

24% have trouble talking about sexual problems.

REHAB RIOS:

SHARYL ATTKISSON: Adjusting to life after a disabling accident can be tough. Some people get depressed. Others get angry. But on New York's Roosevelt Island, there's a man who got busy -- busy helping others in the same situation. Stephani Shelton has his story.

STEPHANI SHELTON: Wheelchairs are a common sight in this part of New York City. And it's no coincidence that just down the street - at Coler-Goldwater Memorial Hospital - Arnulfo Rios designs and constructs special equipment that helps people in wheelchairs win independence.

In 1971 he fell off a ladder and broke his neck. He spent 10 years as a patient here, regaining his own independence.

ARNULFO RIOS: Through the therapy they gave me here in the hospital, the days, the months, years passed by, and I was getting stronger and stronger.

"How are you? How are you doing today?"

STEPHANI SHELTON: Rios was still a patient when - as a volunteer - he began helping other patients.

Today, he is an employee in the occupational therapy department customizing wheelchairs.

ARNULFO RIOS: "Hi, Miss Mollica. How are you?"

STEPHANI SHELTON: For Mary Mollica, it was a cushion, a simple height adjustment that allowed Mollica to get herself from her wheelchair to the bed.

MARY MOLLICA: "He even came down here and saw what the problem was."

ARNULFO RIOS: "How are you doing?"

REGINA LEHMAN, COLER-GOLDWATER HOSPITAL: "Rios kind of takes himself out of his workshop and goes down bedside and really talks to them about I was there, this is me now, you can do it, but you need to get up and you need to come to therapy."

ARNULFO RIOS: "Here at the hospital, it's like family to me."

"Hi, Mr. Siedel. How are you, man? How are you doing? How are you feeling today?"

REGINA LEHMAN: "He always tells me if one person says they appreciate something, it made it all worth it."

ARNULFO RIOS: "It took me a long time to be here the way I am right now. I'm doing the best I can, you know?"

STEPHANI SHELTON: The best Arnulfo Rios can -- for himself and for the rest of this little community on wheels.

SHARYL ATTKISSON: Rios does a lot more than tinker with wheelchairs. One of the newest items in his "independence" tool bag: a mouth stick with a rubber tip that makes it easier for quadriplegics to turn book pages and use computer keyboards.

That's all for this week. Next time, a special edition of HealthWeek: health risks in the home. From toxic mold to radon, we'll give you the latest on the possible health threats lurking under your roof and what you can do about them.

Until then, I'm Sharyl Attkisson. Be well!

ANNOUNCER: For general information about stories in this edition of HealthWeek, please call 1-888-562-8300. Or write to the address on your screen: HealthWeek, Maryland Public Television, 11767 Owings Mills Blvd, Owings Mills, MD 21117.

Funding for HealthWeek is provided by the Howard Heinz Endowment and the Teresa and H. John Heinz III Foundation.

To order a video or a printed transcript of this program, call 1-800-338-8440. Please ask for the program number on your screen. Program #149.

HEALTHWEEK Online is a joint production of:
	and
The Washington Post Company		Maryland Public Television