Prostate Cancer: Understanding the Basics of the Disease

文: 黃俊淵 / 聚和國際 R&D 實習生
攝影師：Pixabay: https://www.pexels.com/zh-tw/photo/40568/

A Potential Killer Men Should Pay Attention To

According to the 2020 GLOBOCAN statistics, prostate cancer is the second most common cancer in men, accounting for 0.2% of all male cancer cases, second only to lung cancer. Prostate cancer is also the fifth leading cause of cancer-related deaths in men (Figure 1) [1]. The prostate is an important male gland that is closely associated with male reproductive behavior. Prostate cancer usually has no obvious symptoms and has similar symptoms to an enlarged prostate that occurs with age. After treatment, there is a chance of recurrence, which shows the threat of prostate cancer to men [2].


(Figure 1) 2020 Male Cancer Incidence and Mortality Worldwide

(Source: GLOBOCAN 2020)
 

Is Obesity Associated with Cancer? Mechanisms and Risk Factors of Prostate Cancer

Prostate cancer is produced by multiple factors through complex interactions, including risk factors such as old age, family history, and race. One obvious factor is obesity. Researchers have found that the physiological mechanisms of obesity are similar to those of tumors, such as inducing blood vessel formation, producing hormones, and chronic inflammation, which happen to be physiological characteristics of cancer [3]. Prostate cancer mainly occurs in the epithelial cells of the peripheral zone of the prostate [4][5]. Cancer begins with chromosomal gene mutations, which promote the generation of the tumor microenvironment. This causes cells to start abnormally growing excessively, recruiting various chemokines, and inducing blood vessel formation (Figure 2). After the body's original repair mechanism fails, the inflammatory response intensifies, leading to accelerated malignant tumor formation, which is called cancer [6].

(Figure 2) Tumor microenvironment generation process, adapted from [6].

 

Treating Prostate Cancer with Androgen Deprivation Therapy

Prostate cancer usually progresses from castration-sensitive prostate cancer (CSPC) that is affected by sex hormones to castration-resistant prostate cancer (CRPC) that is not affected by sex hormones. Currently, ADT (androgen deprivation therapy) is commonly used for CSPC, which reduces testosterone and dihydrotestosterone levels by regulating gene expression and induces autophagy due to hormone deficiency. In addition, hormone inhibitors can be used to block sex hormones from entering prostate cancer cells, slowing their growth rate. Radiotherapy or other treatments such as electrocautery can also be used to remove cancer cells. After a period of ADT treatment, cancer cells develop resistance to drugs, leading to the development of CRPC, which ultimately can only be treated with cytotoxic chemotherapy [7]. In recent years, information technology and CRISPR/Cas9 technology have developed rapidly, and researchers can use CRISPR screening to clarify the cancer process and drug resistance. If combined with other methods (such as mass spectrometry), researchers can more quickly find target sequences within oncogenes and develop research directions and treatment strategies [8].

 

參考文獻：

[1] Sung, H, Ferlay, J, Siegel, RL, Laversanne, M, Soerjomataram, I, Jemal, A, Bray, F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021: 71: 209- 249. https://doi.org/10.3322/caac.21660.

[2]Prostate Cancer Treatment (PDQ® )–Health Professional. (2022). Retrieved August 16, 2022, from https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq#_AboutThis_1.

[3]Kozlov, A.P. Mammalian tumor-like organs. 2. Mammalian adipose has many tumor features and obesity is a tumor-like process. Infect Agents Cancer 17, 15 (2022). https://doi.org/10.1186/s13027-022-00423-5.
[4]Sfanos, K. S., Yegnasubramanian, S., Nelson, W. G., & De Marzo, A. M. (2017). The inflammatory microenvironment and microbiome in prostate cancer development. Nature Reviews Urology, 15(1), 11–24. https://doi.org/10.1038/nrurol.2017.167
[5]Rebello, R.J., Oing, C., Knudsen, K.E. et al. Prostate cancer. Nat Rev Dis Primers 7, 9 (2021). https://doi.org/10.1038/s41572-020-00243-0.
[6]Russo, G., Mischi, M., Scheepens, W., De la Rosette, J.J. and Wijkstra, H. (2012), Angiogenesis in prostate cancer: onset, progression and imaging. BJU International, 110:E794-E808. https://doi.org/10.1111/j.1464-410X.2012.11444.x.
[7]Ziparo E, Petrungaro S, Marini ES, Starace D, Conti S, Facchiano A, Filippini A, Giampietri C. Autophagy in prostate cancer and androgen suppression therapy. Int J Mol Sci. 2013 Jun 6;14(6):12090-106. https://doi.org/10.3390/ijms140612090

[8] Tsujino T, Komura K, Inamoto T, Azuma H. CRISPR Screen Contributes to Novel Target Discovery in Prostate Cancer.  International Journal of Molecular Sciences. 2021; 22(23):12777. https://doi.org/10.3390/ijms222312777.

Release date：2023.03.21

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