Prostate cancer discovered in young men

Prostate cancer remains the most common tumor disease in men

02/12/2013

Prostate cancer is still the most common form of cancer in men in Germany, with more than 60,000 new cases occurring year on year, whereby the risk for older men is particularly high: “Prostate cancer is typically considered a disease of older men. Nevertheless, about two percent of those affected are not yet 50 years old“, such a current press release of the University Clinic Eppendorf (UKE).

Researchers find explanation for early infection
But why do relatively young men get prostate cancer again and again? An explanation for this has now researchers of the UKE together with colleagues of the European Molecular Biology Laboratory (EMBL) in Heidelberg, the German Cancer Research Center in Heidelberg and the Max Planck Institute in Berlin published and published in the journal "Cancer Cell": Accordingly, only few genetic changes are responsible for the development and growth of a tumor - however, the longer a tumor proliferates, the more mutations are caused by genetic instability.

Thus, the number of changes at the beginning of the disease is still relatively small: While in advanced tumors in some cases thousands of mutations exist, in the early stage of prostate cancer show on average about 40 genetic changes, one of which was responsible for the development of the cancer.

Tumor formation by gene fusion
Other interesting findings brought the researchers the study of structural changes in the DNA of prostate cancer patients: So the DNA is indeed complete, but completely jumbled, resulting in breaks and Ablesefehler: „It is only tiny fractures in the genetic material that make the cells susceptible to cancer, "explains Prof. Dr. Thorsten Schlomm, chief physician of the Martini-Klinik, the Prostate Cancer Center at the University Hospital Hamburg-Eppendorf and lead author of the study, for example, chromosome 21 : Because here is the gene on the one hand „TMPRSS2“, which is activated by the male sex hormone testosterone, on the other hand closely next to the gene „ERG“, which is usually active only in embryos and regulates the development of the organs.

If the distance between the two genes breaks down and a merger of the testosterone-dependent gene with the embryonic gene takes place, a tumor could result - because in the case of a gene fusion, whenever the testosterone is applied to the cell, the embryonic gene would also be read. so Dr. Joachim Weischenfeldt from the EMBL and co-author of the published study. Such gene mergers can always occur when the cell attempts to repair genetic defects, Dr. Weischenfeldt on.

Comparison of younger and older patients brings new insights
However, these results are not entirely new - it has been known since 2005 that such gene fusions are linked to the development of prostate cancer. But the research of Prof. Thorsten Schlomm and his colleagues also brought new findings to light: „We have discovered how gene fusions of genes that depend on male sex hormones, the androgens, especially in young men, promote cancer development, and we have also discovered new gene fusions. They ultimately lead to the cell being damaged and becoming more susceptible to further mutations that then lead to the tumor, "said the physician, as the genome of tumors in very young patients compared with that of older patients had 90% of the population However, in older men only 30% of the cases are shown in younger men: "The tumors in older patients, in contrast to the cancerous diseases, are caused by an accumulation of genetic defects over time," explains Dr. Weischenfeld.

These differences were subsequently confirmed in a study of more than 10,000 patients operated in the Martini Clinic. "This is the first time we have proven that age-dependent development mechanisms exist in the case of a common cancer." Weischenfeldt on.

Study raises hope for development of preventive measures
The results of the study raises great hope for the future among the experts: „We hope that our findings will help to develop new strategies for diagnosis and individualized therapy“, says Prof. Schlomm. For example, it is conceivable to treat patients at high risk for this cancer with drugs that reduce the effect of testosterone in the cells.

"Furthermore, we now assume that the new understanding of the origins of prostate cancer now for the first time also the chance to develop effective preventive measures, so that the disease can not even develop“, said the physician - because it is already possible today to detect a gene change in the blood, a standardized test would still be missing. This is in preparation, but could at the earliest be available in three to five years.

Prostate cancer in the family increases risk
The risk of contracting prostate cancer is particularly high for men who inherit the disease - that is, family members of two previous generations have already contracted or two other brothers, for example, in one line: here the risk is many times greater, according to Schlomm "Men from these families are 17 times more likely to have prostate cancer than the general population, and men who have a father, grandfather, or a brother have a 2 to 4 times higher risk.“

Study part of the largest cancer research project in the world
The current study is an integral part of the research carried out as part of the world's largest cancer research project, the International Cancer Genome Consortium (ICGC), funded by the Federal Ministry of Education and Research (BMBF) with 7.5 million euros.

The aim of the consortium is to decode the entirety of the genes of the 50 most important cancers and thereby create a catalog with all the cancer-specific genetic changes. In the research project, which was started at the beginning of 2011, international doctors and scientists are investigating the genetic basis of early prostate cancer - the German team headed by Prof. Thorsten Schlomm had specifically examined prostate carcinomas of very young patients. (Sb)

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