# Small Cell/Neuroendocrine Prostate Cancer: A Rare Treatment-Resistant Variant Presenting as Acute Onset Severe Back Pain

## TL;DR

This paper discusses a rare and aggressive form of prostate cancer that becomes resistant to treatment and presents with severe back pain.

## Contribution

The paper presents a case highlighting the aggressive nature of neuroendocrine prostate cancer and its link to androgen deprivation therapy.

## Key findings

- Neuroendocrine prostate cancer (NEPC) is rare but highly aggressive with poor survival rates.
- Androgen deprivation therapy can lead to neuroendocrine differentiation and the emergence of NEPC.
- There is currently no established screening protocol for NEPC in patients undergoing ADT.

## Abstract

Adenocarcinoma of the prostate is the most frequent subtype of prostate cancer. Being an androgen-driven disease, androgen deprivation therapy (ADT) is one of the mainstay treatments for prostatic adenocarcinoma. ADT however can induce androgen resistance and can cause neuroendocrine differentiation of the cells and subsequently can lead to the emergence of neuroendocrine prostate cancer (NEPC). NEPC, despite being rare, is very aggressive with a very low survival period. The majority of the NEPC cases are treatment-emergent. There is no definite guideline on screening for the development of NEPC for patients who are on ADT. Our case highlights the lethality and aggressiveness of NEPC and the relationship between ADT and NEPC. More research is needed to compare different imaging techniques for early detection and identification of NEPC and to establish screening protocols for patients at risk of developing NEPC while on ADT.