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A Journal on Nephrology and Urology

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Minerva Urologica e Nefrologica 1998 September;50(3):185-90

language: English

New ­aspects on pros­tate can­cer: hereditary form, devel­op­men­tal estro­gen­iza­tion and dif­fe­ren­ti­a­tion ther­a­py

Sciarra A., Casale P., Di Chirio C., Di Nicola S., Di Silverio F.

University of Rome “La Sapienza”, Rome, Department of Urology “U. Bracci”


Three new dif­fer­ent ­aspects of pros­tate can­cer have been con­sid­ered in this ­review: the exis­tence of an hered­i­tary form, the role of estro­gens as pre­dis­pos­ing fac­tors and the effi­ca­cy of dif­fe­ren­ti­a­tion ther­a­pies. Prostate can­cer shows a strong­er famil­ial aggre­ga­tion than colon and ­breast car­ci­no­ma. Hereditary pros­tate can­cer is dis­tin­guished by early age at onset and auto­so­mal dom­i­nant inher­i­tance with­in fam­i­lies. However, only 2% of all pros­tate can­cer in United States white men occur in those 55 years old or young­er. Thus, the ­impact of hered­i­tary pros­tate can­cer in the pop­u­la­tion is the great­est at young­er ages but this ­accounts for only a small pro­por­tion of the total dis­ease bur­den. Using the devel­op­men­tal­ly estrog­e­nized mouse model, an alter­na­tive role for estro­gens as a pre­dis­pos­ing fac­tor for pros­tate dis­eas­es was pro­posed: estro­gen expo­sure dur­ing devel­op­ment may ­initiate cel­lu­lar chang­es in the pros­tate which would ­require estro­gens and/or andro­gens later in life for pro­mo­tion to neo­pla­sia. A com­bi­na­tion ther­a­py employ­ing both dif­fe­ren­ti­a­tion ther­a­py and hor­mone ther­a­py may be effec­tive in the treat­ment of ­advanced pros­tate can­cers. Recent advanc­es in the field of dif­fe­ren­ti­a­tion ther­a­py have result­ed in the devel­op­ment of novel ret­i­no­ic acid metab­olism block­ing ­agents. Unlike pre­vi­ous dif­fer­en­tiat­ing ­agents such as the reti­noids, these ­agents ­increase the endog­e­nous lev­els of ret­i­no­ic acid by inhib­it­ing its break­down in can­cer cells.

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