Prostate Cancer: Etiology, Diagnosis, and Treatment

Abstract

Based on cancer statistics in 2025, 313,780 American men were diagnosed with prostate cancer, and 35,770 of them died from the disease; thus, prostate cancer remains a serious health issue for American men. In this article, we review multiple aspects of the disease, including etiology, diagnosis, and treatment. Regarding disease etiology, we summarize current knowledge of prostate cancer initiation and progression, with a focus on androgen receptor signaling. We discuss the genetic landscape of prostate cancer, including alterations in the DNA damage response pathway, FOXA1, SPOP, the PI3K pathway, WNT signaling, AURKA, and MYCN. We also address the potential contribution of inflammation to prostate cancer development. In the diagnosis of prostate cancer, the Gleason score is discussed. Measurement of prostate-specific antigen (PSA) levels has been the gold standard for diagnosing prostate cancer and monitoring disease progression. We also review additional diagnostic methods, including magnetic resonance imaging, the 4Kscore, the Prostate Health Index, and bone scintigraphy. Various treatments have been used clinically. For localized prostate cancer, active surveillance, radical prostatectomy, radiotherapy, and androgen deprivation therapy are available options. For metastatic prostate cancer, androgen deprivation therapy remains the standard of care. For castration-resistant prostate cancer, cabazitaxel and second-generation androgen receptor inhibitors are the major therapeutic approaches. We also review several non-canonical treatment strategies.