Based on data from a new study from the Johns Hopkins Kimmel Cancer Center, men who demonstrate evidence of chronic inflammation seen in prostate biopsies stemming from chronic prostatitis may have close to twice the risk of developing prostate cancer compared to those without inflammation.
Prostate cancer is the second most common cancer in men in the US.
The link between developing cancer and having chronic inflammation was even more striking for men with aggressive or high-grade prostate cancer, reflected in a Gleason score between 7 and 10. The Gleason score is a numeric scale for assessing risk of developing invasive or high-grade prostate cancer based on microscopic evaluation of prostate tissue.
The research was published April 18 in the Journal Cancer Epidemiology, Biomarkers & Prevention.
The data from the current study is derived from information about men in the placebo arm of the Prostate Cancer Prevention Trial by the Southwest Oncology Group. The goal of the trial was to evaluate if the drug finasteride could prevent prostate cancer. Regardless of whether there were any concerning signs of cancer such as high prostate specific antigen (PSA) levels, the protocol called for biopsies to check for prostate cancer at the conclusion of the trial.
"What we've shown in this observational study is a clear association between prostate inflammation and prostate cancer, although we can't prove that inflammation is a cause of prostate cancer," said Elizabeth A. Platz, Sc.D., M.P.H., a professor in the Department of Epidemiology at the Johns Hopkins University Bloomberg School of Public Health and the School of Medicine.
Dr. Angelo M. De Marzo, Professor of Pathology at Johns Hopkins' School of Medicine and associate director of cancer research pathology explained that inflammation is much too prevalent in men to have any value as way to evaluate men for prostate cancer. But, as De Marzo explained, investigators are trying to understand the factors responsible for prostate inflammation, specifically how it may lead to prostate cancer, and ultimately if it can be prevented. "I think there will be strategies going forward for either preventing inflammation or intervening when it occurs," Platz added.
Platz explained that previous research has evaluated potential links between inflammation and prostate cancer. However, earlier research studied tissue from men who had a specific reason to undergo a biopsy. "Our study was designed to rule out the bias that would ordinarily exist between the way we detect prostate cancer and the presence of inflammation."
"Because inflammation makes PSA levels go up, men with inflammation are more likely to have higher PSA and, with a rising PSA, they're more likely to be biopsied," said Platz. "By doing more biopsies on these men, prostate cancer is more likely to be detected, even if inflammation is not a cause of prostate cancer."
In their study, Platz, De Marzo and their co-investigators studied benign tissue samples taken from the biopsies of 191 men with prostate cancer and 209 men without cancer, examining the samples for the prevalence and extent of immune cells that indicate inflammation. They found that 86.2 percent of the prostate cancer patients had at least one tissue sample with signs of inflammation, compared to 78.2 percent of men without cancer.
"We knew going into this research that inflammation in the prostate is very common in men who have biopsies because of the higher PSA levels and other indicators of prostate cancer, but we did not anticipate the high prevalence of prostate inflammation in men who didn't have an indication for biopsy," explained DeMarzo.
Men with at least one biopsy showing signs of chronic inflammation had 1.78 times higher risk for having prostate cancer, and 2.24 times higher risk of having an aggressive cancer, according to their results. This particular association was also seen in men with low PSA levels at the time of their biopsies.
It is quite clear, based on this study that more investigation will be necessary to definitively link inflammation to increased risk of prostate cancer. Inflammation can be the result of not only infection, but also diet and autoimmune disease.
It turns out that a diet which promotes cardiovascular health also results in improved prostate function. Lower amounts of meat–especially burnt or overcooked meat–is integral for ensuring good prostate health and well as heart health. Getting more aerobic exercise, losing weight and smoking cessation are important measures to ensure a healthy prostate.
Drugs such as statins, which are prescribed for patients with elevated cholesterol and coronary artery disease, may also help reduce the risk of rapidly proliferating prostate cancers. Statins have anti-inflammatory properties which may reduce inflammation which could be leading to high grade prostate cancers.
Other areas to explore include a potential relationship between a history of sexually transmitted diseases and the level of inflammation in the prostate. Whether this may play a role in chronic low grade inflammation is unclear.
Source : http://www.forbes.com/sites/robertglatter/2014/04/21/is-there-a-link-between-prostate-cancer-and-chronic-inflammation/
