Can conception of prostate cancer stem cells influence treatment dedicated to patients with disseminated disease?

No survival profit has been achieved for patients with disseminated prostate cancer since hormonal therapy was introduced. It is proposed that dissemination of rare prostatic cancer stem cells may lead to metastatic disease and that resistance of these cells to androgen ablation makes them responsible for failure of current treatments. In this paper, we will discuss the significance of the stem cell model for understanding prostate cancer pathogenesis. The concept of prostate cancer as a stem cell disease has the potential to change our view of its treatment in the particular case of disseminated disease. The major cellular target of prostate cancer therapy has to be directed against neoplastic stem cells. The combination of molecular-targeted therapy with the concept of the cancer stem cells should be introduced for the treatment of disseminated prostate cancer. Disseminated prostate cancer must be treated with agents directed toward stem cells, while hormone-therapy must be only an additional treatment leading to the decrease of tumor burden.