Many of us believe that prostate cancer is one specific disease, however this is not true. In fact we now know that there are at least twenty-three different types off prostate cancer.
The most common types of prostate cancer, or ninety-five percent of them are referred to as adenocarcinomas.
One of the least common types of prostate cancer is called neuroendocrine prostate cancer or small cell anaplastic cancer . Actually, it occurs in fewer than 2% of all diagnoses prostate tumors. Neuroendocrine prostate cancer is very difficult to treat.
Neuroendocrine prostate cancer unlike adenocarcinoma types of prostate cancer does not make PSA. They are also not responsive to hormone treatments as they lack the androgen receptors found in the other types of prostate cells. They appear to produce their own hormones that can then fuel other forms of prostate cancer cells rendering the hormone manipulations (ADT) we use ineffective.
These cells are found scattered throughout cancer tumors along with other more common types of prostate cancer cells.
The ability of these neuroendocrine cells is so significant that surgeons have reported that when they collect prostate cancer specimens after surgery, the ones in proximity to the neuroendocrine cells grow more rapidly than prostate cancer cells distant from the neuroendocrine variety.
It is very clear that the more of these neuroendocrine cells present in a tumor the worse the prognosis.
Almost 30,000 men who die of advanced prostate cancer every year in the United States have been treated with hormone therapy (ADT). However, it’s been impossible to tell how many of them developed neuroendocrine tumors because men are rarely biopsied at that late stage of their disease.
Currently there is a clinical trial being conducted at Weill Cornell Medical College by Dr. Mark A. Rubin. This trial is the first hope of finding a way to destroy neuroendocrine prostate cancer cells.
According to Dr. Rubin, a professor of pathology at Weill Cornell the study “ demonstrates that the drug (aurora kinase inhibitor PHA- 739358) worked against human neuroendocrine prostate cells in the lab, and that it had a dramatic response in animal models of neuroendocrine prostate cancer.” He added “we hope to develop biomarkers that can help us screen patients for these cells before the cancer advances.”
Joel T. Nowak, M.A., M.S.W.