(RxWiki News) Inflamed tissue seems to play a crucial role in prostate cancer. The presence of inflamed tissue may suggest cancer, even when screening blood tests are not elevated and causing concern.
New research showed that inflamed prostate tissue might signal cancer even when prostate specific antigen (PSA) blood levels were not elevated and when digital exams seemed normal.
"Speak with your doctor if you have concerns about prostate cancer."
The researchers behind this study were led by Elizabeth Platz, ScD, MPH, and Angelo DeMarzo, MD, PhD, of the Johns Hopkins Bloomberg School of Public Health in Baltimore.
These researchers used information from the Prostate Cancer Prevention Trial, which enrolled men who were at least 55 year of age and prostate cancer-free at the time they joined between 1993 and 1997.
For their portion of the study, the researchers included 191 men who had prostate cancer (cases) and 209 men who did not (controls). All the men came in for an annual exam, at which time they were referred for biopsy (removal of tissue sample) if they had PSA levels that were high or an abnormal digital rectal exam. An abnormal PSA is one that is higher than 4 ng/ml.
The men who did not have elevated PSAs or abnormal digital rectal exams were offered a biopsy at the end of seven years.
The researchers found that even when men had normal PSAs and digital exams, they were sometimes found to have prostate cancer if their biopsied tissue was inflamed. Men who had even one core needle biopsy indicating inflammation had 1.78 times higher odds of having prostate cancer than men who did not have any inflammation.
Furthermore, these men had 2.24 times greater odds that their cancer would be aggressive.
Prostate cancer severity is determined by the Gleason Scale, with scores ranging from 2 to 10. Men who had at least one core biopsy that was inflamed were more than two times as likely to have a score of 7 to 10 than men whose biopsies were not inflamed. A score that high usually indicates aggressive cancer.
When the researchers compared all the men in this study, 88.2 percent of men who had been diagnosed with prostate cancer had inflammation in benign (considered cancer-free) areas of tissue, and 78 percent of men who were considered cancer-free had inflamed areas on biopsy.
Inflammation has been associated with other cancers, which made the researchers want to see if they found inflammation among men with prostate cancer.
They found that inflammation was very common among both men with the disease and men not yet known to have the disease. The researchers speculated that inflammation may lead to cancer by some changes it exerts on the cells.
“Our results support the hypothesis that chronic, intraprostatic inflammation influences the development of prostate cancer, particularly high-grade disease,” the authors wrote.
Further studies are now needed and may lead to treatment in men who have the most aggressive cancer, which may be men with the most inflammation, the authors suggested.
This study was published April 18 in Cancer Epidemiology, Biomarkers and Prevention.
Study co-author C. G. Drake is a consultant/advisory board member of BMS and Compugen. W. G. Nelson is a consultant/board member of Glaxo-SmithKline. The authors disclosed no other conflicts of interest.