Metabolic alterations in tissues and biofluids of prostate cancer patients

Abstract Altered metabolism is one of the key molecular characteristics of prostate cancer (PCa) development and a number of studies have searched for metabolic biomarkers in patient-derived samples. Reported metabolic changes in PCa tissue compared to normal tissue include; reduced levels of citrate and spermine, elevated lipid synthesis and fatty acid oxidation, and higher levels of the amino acids alanine, glutamine and glutamate. Recent studies have investigated the tumor microenvironment, such as reactive stroma, and so-called metabolic field effects. Further, analysis of blood and urine samples reveal other, but significant, metabolic differences between PCa patients and controls. Large cohort studies show promising results for assessing future PCa risk from blood samples. Additionally, metabolic profiling of extracellular vesicles from urine has gained interest as a non-invasive and more prostate specific approach to diagnose PCa.