There was something about PC that was befuddling the doctors.  We know that prostate cancer needs testosterone in order to grow.  So many men are treated with androgen-deprivation therapy in order to starve the tumor, but unfortunately, this just buys time for the patient.  The cancer eventually becomes resistant to treatment.   What puzzled scientists was how the tumor continued to grow — even in patients with zero (castrate) testosterone levels. 

Now scientists at the Fred Hutchinson Cancer Center have found the answer: the cancers themselves are producing the testosterone which fuels their growth (from a study published in the June 1 issue of Cancer Research).  The researchers found that “metastatic prostate tumor tissue contains the genetic information needed to make the proteins that produce testosterone and other androgen hormones.”  They add:

“We not only found that metastatic tumor tissues have high enough androgen levels within them to support continued growth of the tumor cells, but also a critically important reason behind why those androgens are there — the discovery that the gene pathways for synthesizing androgens from cholesterol appear to be present in the distant tumor sites. This finding will allow us to start honing in on the specific source of those androgens and how we can eliminate them,” Mostaghel said.

So the cancer, by some alchemy, is making androgens — from cholesterol.  (I have never heard of a connection between PC and cholesterol levels).  This is the bad news.  The good news is that now that we understand the process, we can focus on the tumors themselves and try to find ways to interfere with their testosterone production:

“As we develop new drug targets, we will need to focus on enzymes that seem to be active in the tumor itself. This offers a new way of looking at hormone suppression. In addition to systemic suppression, it suggests we also need to target hormone suppression much more specifically, inside the tumor itself.”