A recent study led by a Mount Sinai oral and maxillofacial surgeon, Dr. David Lam, reports the discovery that a gene called TMPRSS2 is linked to the most severe forms of cancer pain. The study was published in the May issue of the peer-reviewed medical journal Pain.
Dr. Lam is an expert on head and neck cancers. Affecting more than 550,000 people worldwide each year, these cancers are associated with severe localized pain, even at a relatively early stage. Few treatment options are effective for this type of cancer pain, and those that do exist can interfere with the patient’s ability to function independently.
Dr. Lam’s early research led him to realize that the majority of head and neck cancer patients are men, so he began to investigate a correlation to prostate cancer.
“Prostate cancer researchers have found that if a man has the biomarker for the TMPRSS2 gene, his prostate cancer will be much more aggressive. Male hormones seem to trigger the expression of the TMPRSS2 gene,” explains Dr. Lam.
Dr. Lam discovered that the TMPRSS2 biomarker (which is a protein produced by the gene) is also present in patients suffering from head and neck cancers and in much higher quantities than in prostate cancer patients. He is the first researcher to realize the link between TMPRSS2 and pain.
According to clinical data, head and neck cancer is the most painful form of cancer, followed by prostate cancer, while melanoma (skin cancer), sits at the bottom of the pain scale. The team found that head and neck cancers are associated with the highest amount of the TMPRSS2 biomarker, followed by prostate cancer, while breast cancer and melanoma (which are known to be far less painful) were associated with very low amounts of the biomarker.
“It was exactly what we know clinically about pain association,” says Dr. Lam.
As it turns out, the TMPRSS2 protein biomarker is located on the surface of cancer cells, where it comes into contact with surrounding nerve pain receptors. The higher the concentration of TMPRSS2 protein, the more pain the patient experiences.
The discovery opens new doors to develop drugs that target the TMPRSS2 gene to treat hard-to-treat cancer pain far more effectively. It also prompts more questions about whether targeting the TMPRSS2 gene could actually slow the progression of aggressive cancers.