Prostate Carcinoma

Prostate cancer is the most common noncutaneous cancer, and the second leading cause of cancer-related deaths among men in the United States. Approximately, 218,890 new cases of prostate cancer are reported each year in the United States, and ̃ 27,050 of these patients die (Am. Cancer Soc., 2007). However, death rates have been declining primarily owing to early detection, especially screening with the prostate specific antigen (PSA) blood test (discussed later). Briefly, prostate adenocarcinoma develops as a result of continuous and multiple outpouchings of the epithelium with the formations of small ducts and acini showing cytologic atypia and gradual or abrupt loss of basal cells (Mai et al., 2007). High grade prostatic intraepithelial neoplasia is both a precursor of lesions and an accompanying lesion of prostate cancer. The only recognized risk factors for prostate cancer are older age, ethnicity, and family history of the disease. Approximately, 65% of all prostate cancer cases are diagnosed in men 65 years and older; African—American men have the highest incidence rates of this cancer. A diet high in saturated fats and obesity may also be risk factors.

The phenomenon of prostate cancer initiation and progression is slow-advancing and exceedingly complex; some information on the genetic changes, signaling mechanisms, and the roles of the microenvironment and steroid hormones is available. In order to search for an effective prostate cancer therapy, it is necessary to understand molecular strategies responsible for its initiation, progression, and metastasis, which are summarized later.