Biology of Prostate Cancer

Abstract

At present there is no effective therapy for increasing the survival rate in patients with metastatic prostatic cancer. New approaches to this major disease are therefore urgently needed. One approach is to study biology of prostatic carcinogenesis in order to develop a therapeutic modality to prevent the initial development of clinically manifest prostatic cancer. As a general rule for any disease, prevention constitutes the optimal modality if it is at all practically possible. However, the question arises whether prevention of prostatic carcinogenesis is a realistic possibility. Based upon epidemiological data this does in fact appear possible. This is due to the fact that incidence and mortality rates of prostatic cancer in Oriental men are far lower than those in corresponding Western populations. For example, there is a nearly tenfold difference in the mortality rates due to prostatic cancer among men in the United States (14.8 deaths per 100000 men of all ages; [22]) versus Japan (1.8 deaths per 100000 men of all ages; [23]) although the overall life expectancy of men in these two countries is identical (70 in the United States versus 72 in Japan; [26]). When Japanese men migrate to California or Hawaii, however, the mortality rate of prostatic cancer increases dramatically in the first and second generations and becomes more similar to the high rates of United States men than the low rates of native Japanese [12]. These data may demonstrate that prostate carcinogenesis can be directly affected by environmental factors.