研究人员说，他们可能已经解锁了抗性前列腺癌的奥秘。他们希望这会带来更好的治疗方法。
这是男性中第二大诊断的癌症，仅次于皮肤癌。
It’s typically slow growing and there are life-saving treatments available.
但是，有时治疗可以使
Anew study今天由加利福尼亚州拉霍亚的Sanford Burnham Prebys医学发现研究所发行，详细介绍了如何通过挽救生命的治疗方法将前列腺癌转变为一种侵略性和无法治愈的疾病。
Hormones called androgens stimulate prostate cancer cells to grow. Newly developed anti-androgen therapies for prostate cancer are a major advance in the fight against this disease.
睾丸激素和二氢睾丸激素（DHT）是男性的主要雄激素。降低雄激素水平或阻止它们进入前列腺癌细胞可以使这些细胞收缩或生长更慢。
However, men who receive these new treatments are also more likely to develop a deadly, treatment-resistant cancer called neuroendocrine prostate cancer (NEPC). There are no effective treatments for this type of cancer.
In their study, researchers analyzed tissue samples from men with NEPC as well as prostate cancer cell lines and a mouse model of NEPC created by the researchers.
They said they discovered a molecular “switch” that triggers this cancer to become treatment-resistant after anti-androgen treatment.
根据Sanford Burnham Prebys Medical Discovery Institute兼研究的主要作者Maria Diaz-Meco博士，NEPC先前仅占所有已诊断为前列腺癌病例的2％至5％。
不再是这样。现在接近30％。
迪亚兹·梅科（Diaz-Meco）指出：“由于新一代的雄激素抑制剂，情况发生了很大变化，这比早期的雄激素抑制剂更有效。”
The androgen treatments have increased survival against tough-to-treat prostate cancer as well as those where
迪亚兹·梅科（Diaz-Meco）说：“但是这些治疗方法也会导致癌症具有抗药性，例如细菌产生抗生素耐药性。”“靶向治疗后这些神经内分泌肿瘤的发生率现在要高得多。”
PSA测试是用于筛查前列腺癌的血液测试。PSA是前列腺中癌性和非癌组织产生的蛋白质。
The test can detect high levels of PSA that may indicate prostate cancer, but the treatment-resistant cancers can sometimes avoid detection.
“The problem with these new, resistant cancer cells is that they’re androgen indifferent, or androgen independent, which is why the treatments stop working and why they don’t increase PSA levels,” said Diaz-Meco.
未被发现的癌症最终将移至其他地方，通常是肝脏，肺和骨骼。
尽管无法治愈NEPC，但Diaz-Meco的研究最终可能会带来新的治疗选择。
She emphasized that her focus is now on finding a way to “reawaken in some way the androgen receptor pathway” to make NEPC tumors more detectable and treatable.
她说：“我们最初与激酶（某些细胞过程所需的酶）合作的最初观察结果称为异型蛋白激酶C，令人惊讶。”“肿瘤完全缺乏这种蛋白质的存在；通常，肿瘤显示大量这种激酶。”
她认为这一发现可能会导致一种新疗法，从而使这种癌症再次容易受到抗雄激素治疗的影响。
“In general, for prostate cancer, there are two big risk factors,” said Dr. Sven Wenske, urologist and assistant professor of urology at Columbia University Irving Medical Center in New York. “One is ethnicity. For example, African-American men have a significantly higher risk of developing prostate cancer than white men. The other one is a family history of prostate cancer, particularly in a father or paternal uncle, paternal grandfather, or brothers, especially when the disease in those relatives occurred at a younger age.”
“However, there is nothing a man can do to prevent prostate cancer,” Wenske told Healthline. “Early detection is key. And, while there is a lot of controversy about using PSA as a prostate cancer screening marker, patients, especially those at higher risk, should certainly seek out a urologist who will perform an ‘intelligent’ prostate cancer screening.”
智能筛选除了PSA之外，还涉及对生物标志物进行测试，这可以提高筛选精度。
Wenske said this is because “PSA can be influenced by many factors, so instead of looking at PSA as a set number, but rather indicates the risk of cancer over a continuum. For example, some men with a PSA level below 4 ng/ml could be abnormal, but in other patients a PSA greater than 4 ng/ml could be acceptable.”
He explained that additional tests can be helpful in deciding who should undergo a prostate MRI followed by a prostate biopsy to understand which patient has significant prostate cancer that requires treatment.
Wenske说：“如果局部前列腺癌被发现并尽早治疗，那么成功的成功。”
Prostate cancer, when caught early, can be cured. Powerful new treatments called anti-androgen therapy will stop tumor growth and even shrink them.
但是，这种相同的疗法可以产生耐药的前列腺癌，以扩散。
新的研究发现了这种癌症如何变得抗性。它可能指向新的抗雄激素治疗方法，使疾病再次治疗。