Is Prostate Cancer a Sexually Transmitted Disease?

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Don’t you just love sensationalist headlines? As I write, the media is full of reports about the findings of a very recent study addressing this very question – and for once, all of the articles I have read on line and in the papers have been pretty balanced and said ‘Umm, we don’t know’ – which is pretty much the right answer at the moment!

Prostate cancer is one of the most common cancers in men, with about one in nine men being affected by it at some point in their lives, and 40000 men being diagnosed with it in the UK every year. We do not know what causes it; we know that it occurs more often in men over 70, and runs in families including some families where the women have a high risk of breast cancer, but there has not yet been a definite cause identified.

The latest research in this area to hit the media is about Trichomonas Vaginalis, an infection that some women can carry in their vaginas, and which can therefore be transmitted through intimate contact to their partners. We know that trichomonas can cause inflammation in the prostate gland, and we also know that inflammation has been implicated in causing certain cancers, so scientists looked into the possibility that trichomonas causes prostate cancer.

We are still a very long way from knowing the answer! In 2009 a group of very respected scientists in Harvard looked at the information they had collected during the Health Professionals Study – essentially they have studied a group of male doctors in the USA for many years, collecting information about them and watching to see what sort of medical problems they develop, and trying to find any links. When they looked at trichomonas infection and prostate cancer, they found that the men in their study who had trichomonas infection were not more likely to develop prostate cancer overall, but that if they did develop it then it was more likely to be an aggressive from of the disease associated with more serious problems. They have lots of theories about why this is – maybe less aggressive prostate cancer and very aggressive prostate cancer are in fact two different diseases, for example. But they have not reached any conclusions yet.

At the time that they published their findings, they were the first to point out that there were a lot of things about their research that might mean that their findings are not accurate – it had been a few years between the samples that they studied being taken and subsequently being analysed for trichomonas, they were analysed at various labs that might have interpreted them differently, or trichomonas could just be a ‘marker’ for something else – like arguing that cigarette lighters cause lung cancer. While it is true that, generally speaking, people who carry cigarette lighters with them most of the time are more likely to get lung cancer than those who don’t, it’s not the cigarette lighters that are the problem! The same could be true of trichomonas.

The research published this month was essentially a study in a laboratory looking to see if trichomonas affects prostate cancer cells in a way that could possibly lead to cancer, and it seems that yes, it does. But there’s a big difference between what happens in a dish under a microscope and what happens in a real live prostate in a real live man! So while the results are interesting and ‘more research is needed’ (researchers always put this in their publications because it makes people with cash more likely to sponsor further research!), we don’t all need to run to the GP or STI clinic in a blind panic asking to be tested for this cancer causing evil just yet!

This is actually a good example of balanced reporting in the media; even the papers most associated with wildly implausible, attention grabbing, and who are we kidding, paper selling headlines have written very moderate, balanced articles about this issue.

The take home message is that we still don’t know whether finding out whether or not women have trichomonas and then treating those who do will result in fewer deaths from prostate cancer in men in the same way that vaccinating girls against HPV is hoped to reduce deaths from cervical cancer – as the research comes out I’ll keep you posted!

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