Researchers at the Harvard Medical School investigated the effect of androgen deprivation in a preclinical mouse model of stable high grade prostatic intraepithelial neoplasia induced by the loss of the PTEN tumor suppressor. They found that androgen deprivation treatment of these mice accelerated the progression to invasive disease.

Shidong Jia, M.D., Ph.D. And associates found that surgical or chemical castration caused the stable HG-PIN to progress to invasive castration-resistant prostate cancer. Targeting the PI3K pathway pharmacologically or genetically reversed the PTEN-loss induced HG-PIN phenotype. Blocking both the PI3K pathway and the mitogen-activated protein kinase pathway blocked the growth of the castration-resistant prostate cancer.”Together, these data have revealed the potential adverse effects of anti-androgen chemoprevention in certain genetic contexts (such as PTEN loss) while showing the promise of targeted therapy in the clinical management of this complex and prevalent disease,” Jia and colleagues conclude.

This study does not have any direct significance for any man on ADT, but it does point out the very significant potential harms that we might be causing by lumping together all forms of prostate cancer. Prostate cancer, like all other cancers, is not just one disease with every man responding the same to each treatment. A treatment that works for one man might actually be “poison” to another.

We need to spend time learning about the different types of prostate cancer and we need to learn about how these different types of cancers will respond to our potential different treatments. If we don’t, we might actually be doing more harm than good for many men.

the study was published on-line December 20 in Cancer Discovery

Joel T. Nowak, M.S.W., M.A.