Dear OncoLink "Ask The Experts,"
My husband was recently diagnosed with mucinous adenocarcinoma or colloid cancer of the prostate. He was told that the type he has is rare and more aggressive. How rare is it? How much more difficult is it to treat this type of prostate cancer?
Richard Whittington, MD, Associate Professor of Radiation Oncology at the University of Pennsylvania School of Medicine, responds:
This type of prostate cancer is very rare. I thought I saw one case in my experience, but it turned out to be a colon cancer that had spread to the prostate. The old wives’ tales say that it is an unusually bad actor with a poor prognosis, but these reports in the medical literature were single cases, not evaluations of bigger groups of patients. I reviewed the more modern literature, which consisted of very few “large” series of patients, and these suggest that mucinous prostate cancer is no worse than the garden-variety prostate cancer. I could not find any reports on radiation therapy in these men. Most were treated with surgery (i.e. a prostatectomy) and had good outcomes. I believe there is reason to be optimistic. Most of these cases occur in younger men who can be treated by a good urologist with fewer late effects than are seen with radiation. Interestingly, these tumors also demonstrate microsatellite instability, which in the case of colon cancer, portends a less aggressive course and a better response to colon cancer treatment (such as chemotherapy).
Osunkova AO et al. Prognosis of mucinous adenocarcinoma of the prostate treated by radical prostatectomy: a study of 47 cases. American Journal of Surgical Pathology. 2008 Mar;32(3):468-72.
Nagakura K et al Mucinous adenocarcinoma of prostate: a case report and review of the literature. Journal of Urology. 1986 May; 135(5):1025-28.
Jul 28, 2011 - Three gene mutations, MSR1, ASCC1, and CTHRC1, are significantly associated with Barrett esophagus and/or esophageal adenocarcinoma, of which the MSR1 mutation is the most frequent but is only present in a small percentage of cases, according to a study published in the July 27 issue of the Journal of the American Medical Association.
Jul 28, 2011