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Keywords:

  • heterogeneity;
  • prostate cancer;
  • integrin;
  • CD133;
  • tumour stem-cell markers

The articles in the mini-review section once again cover a wide spectrum of topics which should be of interest to the reader. First there is an outstanding paper on a tumour cell hypothesis for the origins of prostate cancer, by one of the leading international experts in the field. The author points out the central role of stem cells, and how their presence may explain both prostate tumour heterogeneity and the variable responses of prostate cancer to several types of treatment.

The other papers compare various technologies in the treatment of small renal tumours, describe some emerging minimally invasive techniques for localized prostate cancer, and present the current status of dynamic lymphoscintigraphy and sentinel lymph-node biopsy in urological malignancies.

SUMMARY

Cancer stem cells undoubtedly exist in many tumour types, including the prostate. This hypothesis can explain both the heterogeneity of prostate tumours and their variable responses to several conventional therapies. In the longer term, therapies directed against tumour stem cells should offer a real possibility of long-term cure, rather than current palliative therapy. Identifying specific tumour stem-cell markers will enhance this process, but the scarcity of these cells within the mass of more differentiated amplifying progeny that comprise >99.9% of most cancers makes this a severe technical challenge. In addition, many tumour stem-cell markers are probably shared with normal stem cells, both in prostate and in stem cells from other tissues, but tumour-specific patterns of gene expression, probably designed to allow the tumour stem cell to survive outside its protective ‘niche’ in normal tissues, will be the best initial targets for new therapeutic agents.