What is the role of inflammation in the etiology of prostate cancer?

Updated: Oct 11, 2019
  • Author: Mark A Moyad, MD, MPH; Chief Editor: Edward David Kim, MD, FACS  more...
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Klein and colleagues at the Cleveland Clinic have produced a working hypothesis that shows the link between inflammation and prostate cancer. [40] Prostatic inflammation is associated with oxidative stress, which stimulates the production of reactive oxidative species (ROS) and reactive nitrogen species (RNS). These bind to DNA and cause mutations. Oxidative stress derived from endogenous and exogenous sources are associated with DNA damage that occurs with aging and plays a role in carcinogenesis. Polyunsaturated fatty acids induce the production of ROS, resulting in the formation of lipid radicals that can cause DNA damage. Semen can also be oxidative, because of the occasional presence of leukocytes and a substantial amount of polyunsaturated fatty acids.

Several mechanisms that can prevent and repair oxidative damage have been identified. Antioxidant enzymes such as phospholipase A-2 remove altered fatty acids, ROS, and RNS, preventing mutations. This one example of the beneficial effects of dietary antioxidants provides evidence that the consumption of foods that promote the production of ROS and RNS should be limited or avoided.

Vance et al reported that dietary antioxidant intake was inversely associated with levels of thioredoxin 1 (Trx 1), an enzyme and subcellular indicator of redox status, in benign prostate tissue in men with incident prostate cancer. Trx 1 levels were positively associated with the Gleason score in these patients. Thus, antioxidant intake may affect the redox status within prostate tissue, which in turn may influence prostate cancer aggressiveness. [41]

In general, risk factors for cardiovascular disease (eg, elevation in weight, blood pressure, and blood cholesterol and glucose levels) involve increased chronic inflammation. Several drugs with established roles in cardiovascular prevention have pleiotropic effects that include anti-inflammatory activity and are being studied for prevention of prostate and other cancers, as well as for adjuvant cancer treatment. Notable examples are statins, aspirin, and metformin (SAM). [6]  

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