Locking Out Prostate Cancer
Paul Mathew is poring over a CT scan of a patient with advanced prostate cancer. He scrolls slowly through cross sections of the body, beginning at the shoulders, moving gradually down to the pelvis while pointing out major organs. The lungs, heart, and liver all look fine, for the most part. The prostate gland is slightly enlarged, and only a few nearby lymph nodes seem swollen.
To my untrained eyes, this seems like promising news, but his patient is in serious trouble. Mathew points to a faint white glow that emerges from each bone he passes. All of them, from shoulder blades to vertebrae to hips, are riddled with cancer cells that have spread from the diseased prostate.
“In most cancers, the tumor isn’t the thing that kills. It’s the metastasis,” he said, gesturing to dying bones and marrow on the scan.
Mathew is a practicing oncologist at Tufts Medical Center and associate professor at the Tufts School of Medicine who specializes in prostate cancer, the second most common form of cancer in American men. Contrary to popular belief, he said, prostate cancer doesn’t metastasize randomly throughout the body—the places it ends up are specific and predictable. It usually homes in on active bone marrow, the stuff that creates our white and red blood cells. But Mathew thinks that specificity might just be the key to treating it.