Blood vessels might predict prostate cancer behavior

COLUMBUS, Ohio – A diagnosis of prostate cancer raises the question for patients and their physicians as to how the tumor will behave. Will it grow quickly and aggressively and require continuous treatment, or slowly, allowing therapy and its risks to be safely delayed?

The answer may lie in the size and shape of the blood vessels that are visible within the cancer, according to research led by investigators at The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in collaboration with the Harvard School of Public Health.

The study of 572 men with localized prostate cancer indicates that aggressive or lethal prostate cancers tend to have blood vessels that are small, irregular and primitive in cross-section, while slow-growing or indolent tumors have blood vessels that look more normal.

The findings were published Oct. 26 in the Journal of Clinical Oncology.

"It's as if aggressive prostate cancers are growing faster and their blood vessels never fully mature," says study leader Dr. Steven Clinton, professor of medicine and a medical oncologist and prostate cancer specialist at Ohio State's Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute.

"Prostate cancer is very heterogeneous, and we need better tools to predict whether a patient has a prostate cancer that is aggressive, fairly average or indolent in its behavior so that we can better define a course of treatment – surgery, chemotherapy, radiotherapy, hormonal therapy, or potentially new drugs that target blood vessels – that is specific for each person's type of cancer," Clinton says.