Fan Wu ^1* Hengsen Zhang ^2* Miaomiao Hao ^1*

• ¹ Department of Pathology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ² Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China

Prostate cancer is one of the most prevalent malignant tumors in men, particularly in regions with a high Human Development Index. While the long-term survival rate for localized prostate cancer is relatively high, the mortality rate remains significantly elevated once the disease progresses to advanced stages, even with various intensive treatment modalities.The primary obstacle to curing advanced prostate cancer is the absence of comprehensive treatment strategies that effectively target the highly heterogeneous tumors at both genetic and molecular levels. Prostate cancer development is a complex, multigenic, and multistep process that involves numerous gene mutations, alteration in gene expression, and changes in signaling pathways. Key genetic and pathway alterations include the amplification and/or mutation of the androgen receptor, the loss of Rb, PTEN, and p53, the activation of the WNT signaling pathway, and the amplification of the MYC oncogene. This review summarizes the mechanisms by which these genes influence the progression of prostate cancer and highlights the interactions between multiple genes and their relationship with prostate cancer. Additionally, we reviewed the current state of treatments targeting these genes and signaling pathways, providing a comprehensive overview of therapeutic approaches in the context of prostate cancer. Black male patients exhibit a more rapid progression of prostate cancer and may develop invasive prostate cancer at an earlier stage [7,8].Early-stage prostate cancer often lacks noticeable symptoms, making it difficult to detect and delaying timely and effective treatment. Currently, the screening and diagnosis of prostate cancer mainly include serum Prostate-specific Antigen (PSA), Magnetic Resonance Imaging fusion ultrasound-guided prostate biopsy (MRI-TRUS), and digital rectal examination. Despite the availability of these methods, PSA remains the most widely used screening tool for early diagnosis of prostate cancer worldwide. Although PSA is highly sensitive for early detection, it lacks specificity of the properties of prostate tissue. This means it cannot differentiate between high-risk and low-risk tumors and may also be elevated in cases of enlarged prostate, aging, prostatitis, certain urological diseases, and specific drug treatments. Consequently, PSA screening may lead to overtreatment of prostate cancer [9].