Hope for men battling hard-to-treat prostate cancer as scientists discover how some tumours become resistant to therapy

Scientists have discovered how some prostate cancers become resistant to therapy, raising hopes of tumors evading treatments.

On average, more than 52,000 men are diagnosed with prostate cancer every year in the UK, making it the most common form of cancer in men.

About 12,000 men die from the disease every year – the equivalent of one man every 45 minutes.

One of the most commonly used treatments for prostate cancer is hormone therapy, which plays a crucial role in stopping the growth of cancer cells.

But some tumors become resistant to the therapy, meaning some patients may eventually see their cancer return and progress.

On average, more than 52,000 men are diagnosed with prostate cancer every year in the UK, making it the most common form of cancer in men. About 12,000 men die from the disease every year – the equivalent of one man every 45 minutes

Two new studies have provided insight into how prostate tumors survive and grow – which could lead to better treatment. In the first study, scientists identified a specific process in prostate cells that helps determine how they evolve from one type of cell to another, which plays a crucial role in determining response to treatment. Pictured: PC-3 human prostate cancer cells stained with coomassie blue, under a microscope

Two new studies have provided insight into how prostate tumors survive and grow – which could lead to better treatment.

In the first study, scientists identified a specific process in prostate cells that helps determine how they evolve from one type of cell to another, which plays a crucial role in determining response to treatment.

There are two types of cells in the prostate: basal and luminal cells.

Whether cancer initially starts in a basal cell or a luminal cell, it almost always adopts the properties of luminal cells as the cancer grows.

Luminal tumors are easier to treat with hormone therapy.

But over time, and in response to treatment, some tumors become less luminal, making them less treatable and more resistant.

While studying this process, researchers saw that when basal cells transform into luminal cells, the way they process a molecule called pyruvate changes.

These changes in metabolism can affect the 'genetic instructions' in the cells that determine how they develop and respond to treatment.

The team discovered that blocking a specific part of cell metabolism and adding a substance called lactate can change cell behavior.

And these changes could potentially affect the success of treatments for prostate cancer, they said.

Dr. Andrew Goldstein, from the University of California – Los Angeles, worked on the study.

He said: 'Identifying metabolic changes and understanding patterns in cancer cells could be a crucial part of developing new cancer treatments.

'New technological developments are giving us insight into how these tumors break down their nutrients – known as cancer metabolism – to help them grow.

'And perhaps we can use or exploit that biology to make tumors more treatable.'

The second study, conducted by the same team, sheds new light on how prostate cancer cells respond when the androgen receptor pathway is blocked – a common approach in treating advanced prostate cancer.

They discovered that a certain protein called MYC plays an important role in how the tumor cells respond to treatment.

“This study teaches us about response to treatment and also suggests that if we could find the right combination of treatments… we could reduce the progression of the disease and its recurrence,” Dr. Goldstein said.

Taken together, the new studies suggest that understanding and controlling these changes could potentially help develop better treatments for prostate cancer, the researchers said.

The first study was published in the journal Nature Cell Biology, while the second was published in Cell Reports.

WHAT IS PROSTATE CANCER?

How many people does it kill?

More than 11,800 men in Britain – or one every 45 minutes – die from the disease every year, compared to around 11,400 women who die from breast cancer.

It means prostate cancer is behind only the lungs and bowels in the number of people it kills in Britain.

In the US, the disease kills 26,000 men every year.

Despite this, it receives less than half of breast cancer research funding and treatments for the disease are at least a decade behind schedule.

How many men are diagnosed annually?

More than 52,300 men are diagnosed with prostate cancer in the UK every year – more than 140 every day.

How quickly does it develop?

Prostate cancer usually develops slowly, so there may be no signs that someone has it for years NHS.

If the cancer is in its early stages and is not causing symptoms, a policy of 'watchful waiting' or 'active surveillance' may be implemented.

Some patients can be cured if the disease is treated at an early stage.

But if the diagnosis is made at a later stage, when the disease has spread, the disease becomes terminal and treatment revolves around relieving the symptoms.

Thousands of men are deterred from seeking a diagnosis because of the treatment's known side effects, including erectile dysfunction.

Testing and treatment

Tests for prostate cancer are haphazard, and accurate tools are only just beginning to appear.

There is no national prostate screening program because the tests have been too inaccurate for years.

Doctors have difficulty distinguishing between aggressive and less serious tumors, making it difficult to decide on treatment.

Men over 50 are eligible for a 'PSA' blood test, which gives doctors a rough idea of ​​a patient's risk.

But it is unreliable. Patients who receive a positive result usually receive a biopsy, which is also not foolproof.

Scientists aren't sure what causes prostate cancer, but age, obesity and lack of exercise are known risks.

Anyone with concerns can speak to the specialist nurses at Prostate Cancer UK on 0800 074 8383 or visit prostatecancer.org

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