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At a superficial level, Parkinson disease (PD) and cancer seem to be like the 2 sides of a coin: uncontrolled cell growth in cancer contrasting with untimely cell death in PD. The underlying mechanisms could therefore be 2 opposite endpoints of those intracellular pathways that regulate the cell cycle, cell death, and cell survival.1 Extrapolating this point, if there is a systemic difference in a person's tendency of cells to undergo programmed cell death, then an individual who has increased risk of PD would have a lower risk for cancer and vice versa.
This hypothesis is supported by the results of a systematic review and meta-analysis of clinical and epidemiologic studies in which the risk of PD and cancer showed an inverse relationship.2 However, at least some of these studies have methodologic shortcomings, and a recent study that controlled for known confounding factors did not reveal a significantly lower prevalence of cancer in patients with PD, either prior to the clinical diagnosis of PD or after they had developed clinically manifest PD.3 The one exception is melanoma, which is more common in PD both before and after the diagnosis of PD is made. This led to the hypothesis that there are common pathogenic pathways …
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