Blood flow and oxygenation status of prostate cancers

Hypoxia is a characteristic of many solid tumors, can lead to the development of an aggressive phenotype and acquired treatment resistance, and is an independent, adverse prognostic indicator. In this literature review, we show that hypoxia is also a typical feature in prostate cancer (PC), the most commonly diagnosed cancer among men in most western countries. Data on blood flow (a major determinant of oxygenation status in malignancies) and on the oxygenation status (as assessed by O(2)-sensitive electrodes) are presented. Where possible, data on prostate cancers are compared to normal prostate (NP) tissue and benign prostate hyperplasia (BPH). The average blood flow rate in NP is 0.21 vs. 0.28 mL/g/min in BPH. Blood flow in PC is approximately three times higher than in NP (mean flow: 0.64 mL/g/min) and shows pronounced intra- and inter-tumor variability. Despite relatively high flow rates in PC, the overall mean pO(2) in cancers is 6 mmHg compared to 26 mmHg in NP. As was the case with blood flow, tissue oxygenation was extremely heterogeneous with no clear dependency on a series of tumor (Gleason score, clinical size, androgen deprivation) and patient characteristics (serum PSA levels, age).