Prostate cancer growth is not always driven by testosterone, which is why hormone treatment sometimes fails.
It’s long been known that testosterone plays an important role in the progression of prostate cancer, but while some men with the disease see tumour growth slow, or even stop, many do not. Now, research from UT Southwestern Medical Center, US shows how late-stage tumours are driven via a different hormonal pathway, which explains why hormone treatment (reducing testosterone levels) may not be effective.
The researchers analysed data from both humans and mice, and found that in advanced prostate cancer cases, testosterone is converted into a more powerful hormone that then accelerates tumour growth. Once this conversion occurs, the cancer is no longer dependent on testosterone to grow. Treatment to reduce testosterone at this stage, therefore, doesn’t have as great an effect.
This research paves the way for a treatment that could target the enzyme which is responsible for initiating production of the more potent hormone. It may also allow researchers to pinpoint other biomarkers that could help doctors ascertain how resistant a cancer is likely to be to testosterone-based treatment, and give different advice based on the test results.

