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Inflammation a shared trait in gastric, liver, prostate cancers

Pank Jit Sin
28 Aug 2019
Dr Seung-ju Lee

Studies on inflammation and infection remain uncharacterized, and are in the early stages with regard to their link to prostate cancer, says a researcher.

Speaking at the recent 17th Urological Association of Asia Congress (UAA) 2019, Dr Lee Seung-Ju, of St. Vincent’s Hospital, Suwon, South Korea, said a number of separate lines of research allude to the potential role of inflammation in prostatic carcinogenesis and tumour progression.

The culprit is likely inflammation
It is believed that as urine travels from the urethra through the prostate and exits the body, urine can seep into the prostate. Bacteria found in the urine could become embedded in the prostate. These bacteria—while not specifically pathogenic—could cause chronic, low-grade inflammation which may lead to cancer.

Lee said chronic inflammation and subsequent development of prostate tumour wouldn’t be the first time such a particular chain of events has happened in the human body. Drawing similes to gastric cancer and its link to Helicobacter pylori, he said: “If you look at the scene of other cancers, such as stomach cancer, we have all the same players we see in prostate cancer.”

A 2014 study (Prostate Cancer Prevention Trial) looking at prostate tissues arrived at the conclusion that chronic inflammation is associated with high-grade prostate cancer. The study went on to note that “the more the inflammation, the higher the odds of having prostate cancer, and of having high-grade prostate cancer.” It further suggested that an avenue for prevention of prostate cancer was by mitigating intraprostatic inflammation. [Cancer Epidemiol Biomarkers Prev 2014;23(5):847–856]

In the case of gastric cancer, the bacterium causes inflammation and ulcers, which leads to gastric atrophy (tissue death), which is a risk factor for cancer. Lee said: “We know there are cancers that are linked to infection, and those infection-linked cancers almost always have inflammation as a cofactor.”

A 2012 study revealed evidence of link between inflammation and prostate cancer. According to pathologists from the Department of Pathology, The Sidney Kimmel Comprehensive Cancer Center, US, Dr Karen Sfanos and Dr Angelo M De Marzo, inflammation and atrophy is commonly seen in specimens taken after prostate cancer surgery, from biopsies and during treatment for benign prostate hyperplasia. These are the same things seen in H. pylori-induced stomach cancers. [Histopathology 2012;60(1):199–215]

Apart from gastric cancer, inflammation is also seen as a contributing factor to the development of primary liver cancer. Lee said: “Chronic inflammation is very well-known in liver cancer. People with hepatitis B or C, when they don’t get rid of the virus, they have chronic inflammation and it ends up damaging the liver. The liver tissue regenerates in the setting of inflammatory cells, and ultimately this can lead to cancer.”

Lee revealed other possible contributors to prostate cancer genesis, namely damage to the prostatic epithelium, dysbiosis of microbiota in the prostate, and consumption of charred meat.

As it is obvious inflammation plays an important role in prostate cancer, Lee hopes further studies will help elucidate the precise mechanisms (of tumour genesis) and provide tools for development of novel strategies to counter the inflammatory process, and thus prevent either prostate cancer or progression of established prostate cancer.  

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