By Dr Ananya Mandal, MD
Prostate cancer is the sixth most common cause of cancer death in men worldwide. As a generally slow growing cancer, an important focus of prostate cancer research is early detection of the condition so that it can be treated promptly and effectively. Other important aspects of prostate cancer research include prevention and effective treatment.
Some of the main areas of research into prostate cancer include:
Scientists are trying to understand the involvement of specific gene mutations that may predispose to prostate cancer. This could help detect cancer risk early on and lead to the development of targeted gene therapies to prevent and treat the disease. For example, recently a mutation in the HOXB13 gene has been associated with an increased risk for hereditary prostate cancer. This is a rare mutation, with studies showing a 1.4% carrier frequency in men with familial prostate cancer.
Other research points at a certain variant of mitochondrial DNA (which a person inherits only from the mother) that may increase the risk for prostate cancer by two or even three times.
While prostate cancer is often slow growing, non-aggressive and confined within the prostate gland for years, sometimes the cancer grows rapidly and spreads to other organs such as the lungs, liver and brain. Research is therefore focused on detecting the types of cancer that are likely to be slow growing and those that are likely to spread, to help aid treatment decisions.
Another area of research is the potential preventative role of diet in prostate cancer. For example, researchers have found that substances such as lycopenes found in tomatoes and isoflavones found in soybeans may help protect against the cancer. Several studies are also analyzing the effects of vitamin E supplementation in the prevention of prostate cancer.
Improved prostatectomy techniques that spare nerve bundles during surgery is an active area of research. Some researchers are now exploring the use of nerve grafts for replacing nerves that get damaged during surgery.
Methods to enhance the precision of targeted radiotherapy are also being researched. More recent radiation methods such as conformal radiation therapy, intensity modulated radiation therapy, high-intensity focused ultrasound and proton beam radiation allow surgeons to specifically target the prostate gland and avoid radiation of healthy tissue as much as possible. These methods are expected to improve the effectiveness of radiotherapy in the future.
Several new forms of hormonal therapy have been developed recently including abiraterone (Zytiga), and enzalutamide (Xtandi). These drugs may prove to be effective even when standard hormone therapies are no longer working.
Several vaccine therapies that are designed to boost the body's immune response to prostate cancer cells are being developed. One example, sipuleucel-T (Provenge) has already received approval from the Food and Drug Administration. Another prostate cancer vaccine (PROSTVAC-VF) that uses a genetically modified virus to trigger an immune attack against cancer cells containing prostate-specific antigen, has shown promising results.
Reviewed by Sally Robertson, BSc
Last Updated: Jan 16, 2014