The disease is defined as the malignant transformation of cells in the prostate gland, a small, walnut-shaped organ that synthesizes seminal fluid. It is one of the prominent male cancers, most experienced by men who have reached old age. 

Global Incidence: It is statistically clinically documented that prostate carcinoma is the third most prevalent cancer in man. Research indicates that it accounts for around half of all cancer cases that develop and causes most cancer-related problems. 

Prevalence: The rate of occurrence is not constant throughout the world and is affected by factors such as hereditary disposition, lifestyle parameters and other available programs. 

Genetic Factors
Hereditary Prostate Cancer: About 5-10% of breast cancers could be attributed to hereditary factors and other genes including BRCA1 and BRCA2 and HOXB13.
Somatic Mutations: Somatic mutations which occur in prostate cells include those affecting the TP53 gene, PTEN, and ETS gene fusions such as TMPRSS2-ERG.
Molecular Pathways
Androgen Receptor (AR) Signaling: Testosterone and DHT are needed for prostate cancer development and progression; AR signaling is sustained in patients with minimal androgen levels (CRPC). 

PI3K/AKT/mTOR Pathway: Dysregulation translates to proliferation; common alterations include PTEN loss. 

Cellular Changes
Hyperplasia and Dysplasia: Starts with PIN (prostatic intraepithelial neoplasia); HGPS is defined as high-grade PIN and is associated with invasive prostate cancer.
Invasive Carcinoma: Transitions from limited to invasive type located in lungs and spreads to legs and lymph nodes.
Hormonal Influence
Androgens: Playing a vital role in prostate growth; treatments aim at lowering androgen levels or inhibiting the AR pathways.
Estrogens and Other Hormones: Estrogen receptor signaling can affect the prostate cancer and hormonal homeostasis affects tumour progression.
Microenvironment and Inflammation
Tumor Microenvironment: Comprises cancer cells, characters of stroma, host leucocytes, and matrix ground substance, which supports cancer growth and promotes metastasis. 

Chronic Inflammation: Among effects of obesity, it raises inflammatory cytokines which contribute to cancer development including prostate cancer. 

Age: Prostate cancer risk rises with age. Men over 50 are diagnosed with most instances. 

Genetics: Prostate cancer risk has been associated with certain genes. 

Race and ethnicity: Nevertheless, African American men were found to be at the highest risk for the disease than Hispanic and white men. Asian American males have the utmost protection against the disease.
Family history: A family history of the disease can also predispose a man. The risk is especially high if the relative was diagnosed when he was still young. 

Stage: Prostate cancer stage also affects prognosis. 

PSA level: Prostate specific antigen (PSA) is a marker or a protein that is released by the prostate gland. PSA is known to be a marker and might be found at high levels in men diagnosed with the prostate cancer.
Age and overall health: It was further observed that the men who are comparatively younger developed prostate cancer, the prognosis of which is generally much higher than that of men of relatively higher age. 

Age Group: 

Age 65 and Older: Men 65 years of age and older receive most prostate cancer diagnoses. This age group is affected by prostate cancer in about 60% of instances. 

Ages 55 to 64: This age category is vulnerable to prostate cancer in high proportions as observed among men. More than a quarter of the patients are men over fifty-five; specifically, 25% of men are affected when they are between fifty-five and sixty-four years old. 

Prostate-Specific Antigen (PSA) Test 

Ultrasound and Biopsy 

• Metabolic Syndrome 
• Other Cancers 
• Benign Prostatic Hyperplasia (BPH) 
• Diabetes Mellitus 
• Cardiovascular Disease

Asymptomatic Presentation
Screening Detection: Most of the prostate cancer diagnosed after employing simple screening techniques like PSA or DRE. In these cases, the man does not manifest signs and symptoms and the cancer is invariably detected during other tests.
Early-Stage Disease: Prostate cases are often localized and have a better prognosis as they are easier to treat.

Symptomatic Presentation
Lower Urinary Tract Symptoms (LUTS): 

Urinary Frequency: Persists, frequent or urgent to urinate specially at night known as nocturia. 

Urgency: A compelling need to pee; a feeling of pressure that one must release urine.
Hesitancy: Difficulty starting urination.
Weak Stream: A reduction in the urine stream’s strength.
Incomplete emptying: Feeling that the bladder hasn’t been emptied. 

Active Surveillance: This strategy is applied concerning low-grade malignancies or slowly progressive androgen-sensitive disease localized to the prostate with less than stage T2 tumor, small volume, clinically localized and not indicated for immediate treatment because of a low likelihood of symptoms or consequences in the coming years. It is controlled by going for routine tests such as PSA tests, digital rectal exams and infrequent biopsies just in case the cancer starts progressing.
Surgery (Prostatectomy): Radical prostatectomy is a surgical procedure that involves the removal of the entire prostate gland and is recommended for the early stage of prostate cancer, which has limited its spread to the prostate gland only. This can involve a direct approach, making an incision in the affected area, or it can involve endoscopic procedures like laparoscopic or robotic surgery.
Radiation Therapy: This can be employed as first-line therapy for prostate cancer that has not spread beyond the gland. 

Types of radiation therapy include:
External Beam Radiation Therapy (EBRT): With the help of a particle accelerator located outside the body, rays with high energy are aimed at the prostate gland.
Brachytherapy: Iodine-125 in the form of radioactive seeds or pellets that are placed near the tumor within the prostate gland.
Proton Therapy: Sites protons instead of photons and this may reduce the chances of certain side effects especially those affecting the tissues surrounding the tumor.
Hormone Therapy (Androgen Deprivation Therapy ADT): Malignant prostate cells possess the potential for growth and survival with the help of male sex hormones or androgens such as testosterone. Hormone therapy works to decrease the levels of these hormones or prevent their action by using drugs or by carrying out the surgical removal of the testicles.
Chemotherapy: When the prostate cancer has affected other parts of the body in addition to the prostate gland and is PSA resistant. Chemotherapy medications are known to remove this abnormal cell tissues and decrease the slow of cancerous growth. 

Urology

• Diet: Increased consumption of vitamins C and E may decrease likelihood of prostate cancer; decreased consumption of red meat and high-fat dairies and increased consumption of fruits, vegetables and whole grains may reduce prostate cancer risk. There are also claims that antioxidants and vitamins E and selenium are beneficial as well. 
• Exercise: Daily working or exercising helps control weight and improve the immune system and hormonal levels that contribute to reducing the intensity of prostate cancer. 
• Tobacco and Alcohol: Smoking raises the risk of developing aggressive prostate cancer. Reduced alcohol consumption aids general well-being and decreases the potential for cancer. 
• Toxins: Adopt practices and recommendations on pesticide use, chemical, and pollutants to reduce prostate cancer incidence where durations of exposure are long, especially in working environments. 
• Screening: It is more effective to go through the prostate cancer screening for regular basis so that this cancer is easy to diagnose and treat at an early stage.
• Stress Management: Stress is a causative agent and could be managed while practicing Mindfulness, Meditation or doing other related activities to improve health hence reducing the probabilities of cancer.
• Vitamin D: Consequently, Intake of approximated amounts of vitamin D though sunbathing or supplements may help prevent prostate cancer but further study is needed.
  Social Support: Close bonds with family and friends and their support could improve everybody’s well-being and cope with stress appropriately. 

Urology

• Leuprolide: Leuprolide acts on binding and stimulating GnRH receptors in the pituitary gland. 
  It is used in cases like prostate cancer, endometriosis and uterine fibroids.
• Triptorelin: Triptorelin is utilized in the therapy of prostate carcinoma. It helps in the inhibition of LH and FSH thus lowering testosterone levels which can help in slowing down the development of the prostate cancer cells. 
  

Urology

• Abiraterone: Abiraterone specifically inhibits the enzyme CYP17A1 (17α-hydroxylase/17,20-lyase,), involved in molecular generation of androgens in the adrenal tissue and in the prostate cancer cells.
• Bicalutamide: Bicalutamide is an antagonist of the androgen receptor, it gets into the prostate gland where it blocks binding to the androgen receptors by testosterone and other androgens. This inhibition counteracts the growth promoting influence of androgens on some malignancy of the prostate gland.

Urology

Sipuleucel-T 
Sipuleucel-T (Provenge) is considered as immunotherapy which is effective for individuals who have advanced prostate cancer. They operate through the enhancement of the patient’s immunity to fight the prostate cancerous cells. 

Urology

Zolendronic acid (Zometa) 
This is a bisphosphonate drug under the trade name Zometa, and it is approved for use in the treatment of prostate cancer especially in patients whose disease has advanced or has spread to the other parts of the body. It acts through prevention of bone resorption that is a process catalysed by osteoclasts, because the drug aids in maintaining a low incidence of skeletal related events (SREs) such as fractures, spinal cord compression, bone radiation or surgery. 

Urology

• Radical prostatectomy: A radical prostatectomy removes the prostate gland entirely as well as any surrounding tissue, including seminal vesicles.
• Transurethral Resection of the Prostate (TURP): This procedure can be used to treat benign prostatic hyperplasia (BPH), which is an enlarged prostate. However, it is not usually used to treat prostate cancer. 

Urology

• Screening: First, screening tests are, PSA testing and DRE.
• Biopsy: Conclusively confirms cancer, helps to determine its degree, and stage.
• Imaging: Current test to evaluate cancer include the MRI, CT scans, or bone scans.
• Treatment Planning:
  Risk Assessment: It stratifies cancer into risk tiers based on low, intermediate, and high risk.
• Treatment Modalities:
  Decisions depend on the stage, grade, and the state of health of the patient. This consist of simple invasive procedures like wait & watch, surgery, radiation therapy, hormonal therapy, chemotherapy and immunotherapy
• Monitoring and Follow-Up:
  PSA tests and check-ups are conducted to provide information about the diseases.
  Further imaging as necessary to address recurrence of the cancer or metastases.
  As a result of follow-up and response, changes to frequency, dosages or medication types may be necessary.
• Management of Recurrence or Advanced Disease: There are whole-body therapies for secondary cancer.
  Patients need to access palliative care as the quality of life is enhanced.