Challenges and Emerging Therapeutic Approaches in Prostate Cancer

With its complex genetic pathways and numerous documented cases of clinical evidence, prostate cancer is still the most frequently reported cancer within the male population across the world. However, despite the advancements that have occurred within the diagnosis and treatment of the disease, there are still bounds to be surpassed to effectively manage the long-term situation of the illness and to further successfully enhance the quality of life of the patients falling under this category. This chapter describes in-depth the biological pathways of prostate cancer, which include, but are not limited to, issues such as androgen receptor signalling pathways, genetic/epigenetic modifications, as well as the relationship between the tumour microenvironment and tumourigenesis, progression, and resistance. In addition, this chapter will assess the bounds of the innovative treatment approaches within toxicity, resistance mechanisms, and recurrence of the diseases, as well as surgery, radiation therapy, androgen depletion therapy, immune therapies, and chemotherapy. The chapter starts with some information about the biology of prostate cancer, with specific areas including the androgen receptor signalling pathways, genetic and epigenetic changes in the tumour cells of the prostate, and the tumour microenvironment and the initiation and development of the tumour and its resistance to therapies. It then critically discusses the latest treatments for the disease, including surgical therapies, radiation therapy, androgen deprivation therapy, chemotherapy, and immune therapies, mainly in consideration of the challenges posed by the adverse effects and the development of resistant tumours.