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

Copyright © 1999 EDIZIONI MINERVA MEDICA

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”


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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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