Report: Painkillers could prevent prostate cancer Investigator: William G. Nelson Saturday Apr 6th, 2002 by Apoorva Mandavilli Inflammation as the earliest stage in the development of prostate cancer is now the most exciting idea in the field, a leading prostate cancer expert said today. Anti-inflammatory drugs used commonly for pain relief are one of many new strategies now being pursued to prevent prostate cancer. Although prostate cancer has reached epidemic proportions, particularly in the developed world, scientists are just beginning to discover how the disease progresses and how to prevent it, says Nelson, who is associate professor of oncology at Johns Hopkins University. Nelson and his collaborators recently identified regions of focal atrophy in prostate cancer, which he calls "the number 1 finding in the field in the last decade." Cells in these regions do not fully differentiate and are "awash with inflammation," he noted. The first step in prostate cancer progression may be an infection that transforms the cells from normal tissue to proliferative, inflammatory atrophy, Nelson suggests. Because scientists have never been able to pin down a pathogen in the area, however, he described the infection as "hit-and-run." The cells then progress to prostatic intraepithelial neoplasia, to localized cancer and, finally, to metastatic cancer. During the entire process, which can last 20 or 30 years, the cells are exposed to and awash with oxidants and electrophiles. "That goes on for a very long time," Nelson said. "It gives us a lot of opportunity to intervene, at least to slow this process down." There may be ways to use chemoprevention to avert prostate cancer or at least slow its growth, Nelson says. Levels of selenium drop with age, for example, and correlate with increased incidence of prostate cancer. Sulforophane, found in cruciferous vegetables, is another potential target. New data is emerging constantly to support one or another chemopreventive agent, Nelson says. But which to pursue is far from clear. Once recent promising strategy is to inhibit COX-2 expression in the inflammatory cells around the focal atrophy. COX-2 is expressed at high levels in various types of precancerous and cancerous tissue, including prostate cancer, and levels of the protein increase as the cancer progresses. COX-2 inhibitors "are ideal for cancer prevention" and several are in clinical development, notes Gary Kelloff, an oncologist at the US National Cancer Institute. COX-2 inhibitors are marketed now for pain relief and other purposes, and selective inhibitors "will prove to be safe," he predicted. A second possibility for therapy is the restoration of glutathione S-transferase (GSTP1). In 1994, Nelson's team discovered that hypermethylation of GSTP1 is the most common somatic genome alteration in human prostatic carcinoma cells. Hypermethylation inactivates the GSTP1 gene and renders cells vulnerable to the damaging effects of electrophiles and oxidants. Methyltransferase inhibitors like procainamide restore GSTP1 function and can help protect cells from further damage, Nelson says. The researchers are now considering clinical trials for procainamide. However, its use in the current form may be limited by heart-related side effects, Nelson points out. Currently the drug is prescribed for arrhythmias. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.