Prostate cancer: How it becomes resistant to treatment

Surprising discovery

While there is no cure for NEPC, Diaz-Meco’s research may eventually lead to new treatment options.

She emphasised that her focus is now on finding a way to “reawaken in some way the androgen receptor pathway” to make NEPC tumors more detectable and treatable.

“Our initial observation working with a kinase (an enzyme needed for certain cell processes) called atypical protein kinase C was surprising,” she said. “The tumors were completely lacking the presence of this protein; typically tumors show high amounts of this kinase.”

She thinks this discovery may lead to a new treatment, one that can make this cancer vulnerable to anti-androgen therapy again.

Early detection is best defense

“In general, for prostate cancer, there are two big risk factors,” said Dr. Sven Wenske, urologist and assistant professor of urology at Columbia University Irving Medical Center in New York. “One is ethnicity. For example, African-American men have a significantly higher risk of developing prostate cancer than white men. The other one is a family history of prostate cancer, particularly in a father or paternal uncle, paternal grandfather, or brothers, especially when the disease in those relatives occurred at a younger age.”

“However, there is nothing a man can do to prevent prostate cancer,” Wenske told Healthline. “Early detection is key. And, while there is a lot of controversy about using PSA as a prostate cancer screening marker, patients, especially those at higher risk, should certainly seek out a urologist who will perform an ‘intelligent’ prostate cancer screening.”

Intelligent screening involves testing for biomarkers, besides PSA, which can improve screening accuracy.

Wenske said this is because “PSA can be influenced by many factors, so instead of looking at PSA as a set number, but rather indicates the risk of cancer over a continuum. For example, some men with a PSA level below 4 ng/ml could be abnormal, but in other patients a PSA greater than 4 ng/ml could be acceptable.”

He explained that additional tests can be helpful in deciding who should undergo a prostate MRI followed by a prostate biopsy to understand which patient has significant prostate cancer that requires treatment.

“If localised prostate cancer is detected and treated early, the success with that is very good,” Wenske said.

The bottom line

Prostate cancer, when caught early, can be cured. Powerful new treatments called anti-androgen therapy will stop tumor growth and even shrink them.

But, this same therapy can create treatment-resistant prostate cancer that will spread.

New research has found how this cancer becomes resistant. It may point the way to new anti-androgen treatments that make the disease treatable again.

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