Genetics, epigenetics, and the evolution of prostate cancer


If you are one of our readers who is really “into” the underlying causes of and development of prostate cancer, then you probably want to see if you can read a newly published article in this week’s New England Journal of Medicine. This article by Arap et al., entitled “Prostate cancer progression and the epigenome,” addresses factors that appear to be highly relevant to why some men get prostate cancer and others don’t, and also to why prostate cancer progresses in some men and not in others. However, …

  • You will need some background in the biological sciences to be able to appreciate the nuances of this article.
  • The article does not provide simple answers to how we might be able to better manage prostate cancer (yet).
  • The article does carefully note that doing research in this area is very difficult (for a multiplicity of reasons) and so it is possible that the recent “findings” discussed by Arap et al. could be fundamentally flawed because of the tools and materials currently available.

Having made these three points, what Arap et al. are telling the medical community, based largely on findings from a very large study of the genetics and epigenetics of prostate cancer by Pomerantz et al. in Nature Genetics, is the following:

  • The presence of certain specific proteins in normal prostate tissue appears to impact risk for the development and progression of prostate cancer.
  • There may be a strong association between factors associated with the earliest stages of prostate development (i.e., in a male fetus) and later risk for prostate cancer development.
  • Hereditary (germline) gene variants may impact the epigenetic activity of prostate-specific regulatory elements of gene expression, potentially leading to the development and evolution of prostate cancer.

What is very interesting about this article by Arap et al. (and the underlying research done by Pomerantz et al.) is how it points toward a spectrum of new research opportunities that may become useful in the diagnosis and management of prostate cancer in the future.

What is not so clear is how many of you may be able to actually access the article by Arap et al. Your sitemaster was able to read it for free, but he wasn’t expecting to be able to.

2 Responses

  1. Anyone can read a couple of NEJM articles every month for free by signing up for a free account. They send you a list of articles for every issue.

  2. Thanks. I will have a go at it.

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