Though a range of cancers can cause pain for sufferers, studies have shown tumors in the head, neck and prostate to cause the most discomfort. New research has shed more light on the source of this pain, identifying a certain gene as the trigger and giving scientists hope of developing better targeted pain relief therapies.

Dr David Lam of the University of Toronto started out by examining cancers in the head and neck, conditions said to affect more than 550,000 people around the world each year. Through this research, Lam happened upon an interesting discovery: that the majority of these patients are male. This prompted him to explore the role of a genetic marker called TMPRSS2, the heightened presence of which has been shown to correlate with more aggressive forms of prostate cancer.

What Lam found was that the TMPRSS2 gene was indeed present in sufferers of head and neck cancers, and in even greater volumes than prostate cancer patients. He was able to observe the activity of TMPRSS2 on the surface of the cancer cells, watching as the gene came into contact with the body's nerve pain receptors.

The TMPRSS2 gene (seen in green) has been identified as a trigger for severe cancer pain (Photo: University of Toronto/D. Lam)

Perhaps the most important finding to come from Lam's research was the establishment of a clear relationship between the levels of TMPRSS2 and the levels of pain experienced. He found that the more of the gene that comes into contact with the nerve pain receptors, the greater the pain experienced.

He and his team built on this by investigating the role of TMPRSS2 in other forms of cancer also known to cause pain, albeit to a lesser degree, such as in the breast and melanomas. The team found that the levels of TMPRSS2 aligned perfectly with what earlier studies had suggested about the amounts of pain associated with these different cancer types.

The identification of TMPRSS2 as the instigator of cancer pain suggests that mitigating its expression could pave the way for new forms of pain relief. This may see more targeted cancer treatments that limit its production or its ability to penetrate the body's nerve pain receptors, thereby providing new pain relief options, which are currently limited to opioid-family pharmaceuticals such as morphine.

"The discovery that TMPRSS2 drives cancer pain demonstrates another way that cancers lead to suffering," says Dr Brian Schmidt of New York University College of Dentistry and one of the study's co-authors. "Inhibition of its activity in patients might provide a new form of treatment for cancer pain.”

The research was published in the journal Pain.

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