Updated May 18, 2015.

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Prostate Cancer and STDs

According to the latest medical research, malignancy of prostate gland is very strongly linked to sexually transmitted infections. It is imperative to understand that prostate cancer claims approximately 5.0% of all cancer related deaths in United States; making it a serious health concern for aging males and healthcare professionals (1).

Additionally, based on the new statistics released by Centers for Disease Control and Prevention (2), more than 20 million new cases of sexually transmitted infections were reported last year in the United States; thereby increasing the total prevalence of STIs to about 110 million adults.

• But how does sexually transmitted infections contribute to the pathogenesis of prostate cancer?
• What are some infectious agents that are more likely to increase the risk of prostate cancer?
• How to control or reduce the chances of developing this cancer?

Evidence based review of sexually transmitted infections in the pathogenesis of Prostate cancer:

Extensive research and clinical trials to explore the pathophysiology of prostate cancer suggested that males who develop recurrent episodes of sexually transmitted diseases are more likely to develop this malignancy.

Hayes and Pottern conducted an extensive case-control study on 2296 males to identify the potential risk factors in the setting of prostate cancer (3). The study concluded that the risk of prostate malignancy is 1.6 times higher in males who report a recurrent history of sexually transmitted infections like syphilis or gonorrhea. Due to high prevalence of infections like gonorrhea and syphilis globally, this association is a matter of grave concerns.

Several other sexually transmitted infections are also implicated in the pathogenesis of prostate cancer. For example, study reported in the peer reviewed journal Proceedings of the National Academy of Sciences (4) suggested a strong link between parasitic infections like Trichomonas vaginalis (transmitted sexually) and prostate cancer. Another study reported in the scientific journal Tumor Biology (5) suggested HPV (human papilloma virus) DNA was found in the tissue samples of prostate cancer; suggesting positive evidence of HPV-mediated gene polymorphism in infected subjects.

In simple words, it can be safely concluded that:

• Almost all sexually transmitted infections (bacterial, parasitic and viral) can aggravate the risk of developing prostate cancer.
• The biological characteristics of infectious agents can determine the pathophysiology of prostate cancer.
• Prevention of sexually transmitted infections can minimize the risk of developing prostate malignancy and possibly other cancers.

Pathogenesis of Prostate malignancy in the setting of STDs:

The exact mechanism is not known, but experts believes that sexually transmitted infections are capable of inducing pro-inflammatory changes in the lining cells of prostate gland. In case of chronic infections, repeated bouts of inflammation leads to proliferative atrophy of the prostate gland to cause intraepithelial neoplasia (a pre-cancerous stage) and eventually full-blown prostate malignancy (6).

In addition, different infectious agents have different mechanisms of action as well; for example, investigators explained that the parasitic colonization in case of Trichomonas vaginalis infection is followed by the secretion of an abnormal protein that interferes with the normal functioning of immune system; thereby aggravating the risk of prostate cancer. Likewise, viral agents like HPV induce genetic changes in the prostate gland (especially involving p53 gene) to induce carcinogenesis.

What are some risky behaviors that may aggravate the risk of prostate cancer?

According to the study reported in the British Journal of Cancer (3), following risk factors are strongly linked with the malignancy of prostate gland:

• History of unprotected sexual intercourse
• Multiple sex partners
• Chronic infections and poor overall immune health. For example, the risk of prostate malignancy is 3.3 times higher in males with recurrent history of exposure to gonorrhea (3).

How to reduce the risk of Prostate cancer?

The risk of contracting sexually transmitted diseases can be reduced by:

• Practicing safe sex
• Using protection (physical barriers like condoms) during chance sexual encounters
• Identifying the symptoms of sexually transmitted diseases by educating yourself about various causative agents and key symptomatology
• Seeking medical treatment as early as possible to minimize the risk of chronic inflammatory damage to vital tissues

Strong association of prostate cancer with sexually transmitted infections offers remarkable opportunities for researchers to devise new methods and strategies for the optimal control, prevention and management of STIs.

References:

1. http://seer.cancer.gov/statfacts/html/prost.html

2. http://www.cdc.gov/std/stats/sti-estimates-fact-sheet-feb-2013.pdf

3. Hayes, R. B., Pottern, L. M., Strickler, H., Rabkin, C., Pope, V., Swanson, G. M., ... & Fraumeni Jr, J. F. (2000). Sexual behaviour, STDs and risks for prostate cancer. British journal of cancer, 82(3), 718.

4. Twu, O., Dessí, D., Vu, A., Mercer, F., Stevens, G. C., De Miguel, N., ... & Johnson, P. J. (2014). Trichomonas vaginalis homolog of macrophage migration inhibitory factor induces prostate cell growth, invasiveness, and inflammatory responses. Proceedings of the National Academy of Sciences, 111(22), 8179-8184.

5. Michopoulou, V., Derdas, S. P., Symvoulakis, E., Mourmouras, N., Nomikos, A., Delakas, D., ... & Spandidos, D. A. (2014). Detection of human papillomavirus (HPV) DNA prevalence and p53 codon 72 (Arg72Pro) polymorphism in prostate cancer in a Greek group of patients. Tumor Biology, 35(12), 12765-12773.

6. Cheng, I., Witte, J. S., Jacobsen, S. J., Haque, R., Quinn, V. P., Quesenberry, C. P., ... & Van Den Eeden, S. K. (2010). Prostatitis, sexually transmitted diseases, and prostate cancer: the California Men's Health Study. PLoS One, 5(1), e8736.

7. NELSON, W. G., DE MARZO, A. M., DeWEESE, T. L., & ISAACS, W. B. (2004). The role of inflammation in the pathogenesis of prostate cancer. The Journal of urology, 172(5), S6-S12.