Thursday 28 August 2008

Why Hormone Therapy For Prostate Cancer Ultimately Fails

�Some of the drugs given to many hands during their fight against prostate cancer can really spur some cancer cells to grow, researchers have found. The findings were published on-line this hebdomad in a pair of papers in the Proceedings of the National Academy of Sciences.



The results crataegus laevigata help explain a phenomenon that has bedeviled patients for decades. Hormone therapy, a vulgar treatment for men with advanced prostate cancer, in general keeps the cancer at bay for a year or two. But then, for reasons scientists have never silent, the handling fails in patients whose disease has spread - the cancer begins to grow again, at a time when patients feature few handling options left.



The new findings by a team lED by Chawnshang Chang, Ph.D., director of the George Whipple Laboratory for Cancer Research at the University of Rochester Medical Center, help excuse the process by exhibit that the androgen receptor, through which male hormones like testosterone work, is much more versatile than previously thought. Under certain conditions the molecule spurs growth, and at early times the molecule squelches growth - just like the same molecule does to hair in different locations on a man's head.



The newfangled findings raise the possibleness that under some conditions, some treatments designed to treat prostate cancer could instead take out one of the body's natural brake system on the spread of the disease in the body. The researchers stress that the results are based on laboratory studies and on findings in mice, and it's excessively soon to know even whether the findings apply directly to prostate cancer in men.



Understanding the personal effects of the androgen receptor gives physicians a toehold in efforts to recrudesce more effective treatments for men with prostate cancer. That would be welcome news for the unrivalled of every six men who will get the disease during his lifespan. More than 28,000 men die from the disease in the United States each year, according to the American Cancer Society. Men's risk from prostate cancer is or so equal to women's risk of infection from breast cancer: Each year, around the same number of men scram prostate genus Cancer as women get knocker cancer, and their risk of dying from the diseases is about equate, according to ACS.



Chang's findings are most relevant for patients with advanced prostate gland cancer, wHO typically receive hormone therapy after other treatments such as operating room or radiation. With internal secretion therapy, physicians blunt the effects of male hormones like testosterone to bring the disease in the prostate to a staunch. One variety of hormone therapy works by blocking the androgenic hormone receptor. Androgen deprivation therapy is mostly very effective for a year or two, merely for reasons that no one has understood, the cancer ultimately returns.



"When a man receives hormone therapy, initially the treatment works well, and his PSA (prostate specific antigen) grade goes down," said Edward Messing, M.D., a urologist and an author of the newspaper publisher. "But of necessity, the PSA will start climbing again, and that is commonly the first sign that the intervention is beginning to fail. It's a sign that the cancer in the prostate is making a comeback."



In work funded by the National Cancer Institute, Chang's team found that blocking the receptor indeed prevents some cells in the prostate from growing, just as scientists expected. But Chang's team unexpectedly found that blocking the receptor actually spurs other prostate cells to grow.



"The androgen receptor acts otherwise in different cells in prostate tissue paper," said Chang. "It's always been false that blocking the androgen receptor will stop all prostate cells from development, but we have found that that's not the case. Since current discourse acts nonspecifically on all the cells having androgenic hormone receptors in the prostate gland, blocking the androgen sensory receptor will grant mixed results."



The team ground that, as expected, the androgen receptor in prostate gland support cells known as stromal cells stimulates growth of cells, including genus Cancer cells, in the prostate gland. He too found, amazingly, that the receptor actually acts as a neoplasm suppressor in epithelial cells known as basal cells in the prostate.



Then Chang's team knocked out the androgen sensory receptor in specific sets of prostate cells and studied the results. As expected, when the molecule is turned off in stromal cells, growth of cancer cells in the prostate gland slows. But when the molecule is turned off in the epithelial cells, it removes one of the body's natural inhibitors that prevents prostate cancer cells from spreading, fashioning cells more likely to invade other tissues.



"While the androgen sense organ is really driving prostate cancer, in another sense it appears that the receptor besides normally inhibits the spread of cancer the Crab cells. It seems to have a dual role. Manipulating the androgen receptor can growth or diminution either of these actions depending on precisely how it's through," said Messing.



Chang says the molecule's versatility in the prostate should not come as a surprise, since the molecule's function elsewhere depends on its location.



"The effects of the androgenic hormone receptor on hair growth in men vary dramatically depending on where in the body the receptor is working," said Chang. "When the receptor is very active in the mustache area, more hair grows. When it's very active on the cover of the skull, toward the social movement, hair waterfall out and men become bald. And the whisker on the back of the heading is insensitive to the receptor. The effects of hormones calculate on the location.



"We base that the same is true inside the cells of the prostate itself," said Chang, who is a faculty member in the departments of Urology and Pathology and the James P. Wilmot Cancer Center.



Chang says it's potential that the androgen receptor works otherwise in different cells partly because the assortment of molecular colleagues it works with inside the body changes from situation to situation. Like a foreman turning to a pool of employees to take certain jobs done, the androgen receptor taps unlike molecules in different situations, forming intricate complexes or groupings that then execute various tasks. The sense organ works very quickly, assembling a team within seconds, accomplishing a task, then disbanding and making its helpers available to cast a stigma new team for some other task.



Chang's squad is working on ways to focal point on these molecular "co-factors" as a way to target the androgen sensory receptor differently in different cells, for example, turning sour the sensory receptor in some cells piece keeping it on in others, to fight prostate gland cancer. That type of cell-specific targeting is currently not possible.



The research in the testing ground involved tracking the disease in mice and too analyzing human prostate cancer cells in culture. Nevertheless, the work might let in some hints for improving patient care. Possibilities include studying whether androgen suppression therapy might be used to mark only specific cells within the prostate gland, as well as checking whether drugs designed to prevent cancer from public exposure should be used in concert with hormone therapy.





Chang's team included researchers Yuanjie Niu; Saleh Altuwaijri; Kuo-Pao Lai; Chun-Te Wu; William A. Ricke, Ph.D., assistant professor of Urology; Jorge Yao; Shuyuan Yeh, Ph.D., associate professor of Urology; Shengqiang Yu; Kuang-Hsiang Chuang; Shu-Pin Huang; and Edward Messing, M.D., professor and chair of Urology. Henry Lardy of the University of Wisconsin is an author on one of the papers.



Source: Leslie White

University of Rochester Medical Center




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