In summary, we found differences between prostate cancer cells and CAFs using tissues from 480 patients, showing elevated expression of MCT4 and CAIX in CAFs and demonstrating for the first time that the concomitant expression of MCT1 in tumour cells and MCT4 in fibroblasts in the same tissue is clinically significant, and associated with poor prognosis. Here, CA9 is linked to Familial prostate cancer.