Understanding the Epidemiology, Natural History, and Key Pathways Involved in Prostate Cancer

In 2009, prostate cancer (PCa) was a significant health concern, representing 25% of all new cancer diagnoses in American men and causing an estimated 28,000 deaths. The incidence rate for Black men was approximately 1.6 times higher than for white men. With an aging population, new cases were expected to rise by over 60%, reaching 300,000 by 2015. High-grade prostatic intraepithelial neoplasia was identified as a potential precursor to PCa, indicating a group of men at higher risk for the disease. The hormone dihydrotestosterone, produced from testosterone by 5alpha-reductases, was found to be crucial in both normal prostate growth and PCa development. Increased levels of 5alpha-reductase, especially type 1, were observed as PCa progressed, suggesting that inhibiting this enzyme could reduce PCa risk, slow progression, or treat the disease. Research efforts were focused on understanding the disease pathways, particularly targeting the 5alpha-reductase pathway for PCa prevention and treatment strategies.