Molecular Mechanisms Involved in the Transition of Prostate Cancer Cells from Androgen Dependant to Castration Resistant State

Prostate cancer is an internationally important health problem of the man, particularly in developed countries. Currently the main line of treatment for prostatic cancer is based on androgen deprivation. The androgen blockade treatment is initially effective on androgen dependent cancer, but the disease relapses within a period of around two years with a more aggressive form named castration resistant cancer. The growth and expansion of castration resistant cancer are not dependent on androgen supply anymore and thus is more difficult to treat. Understanding the molecular mechanism involved in the transition of prostate cancer cells from androgen dependent to androgen independent state is the key for designing a biologically appropriate strategy for a more effective treatment. Currently, several different theories have been brought about to address this transition process and based on these theories, several lines of treatments were introduced for the castration resistant disease. Despite the advances in our knowledge of prostate cancer cell transition, no current theoretical explanation can satisfactorily cover all aspects of this transition process and no curative treatment of the castration resistant disease is available. In this review, we summarized and commented several major current theories to explain the molecular pathology on the transition of prostate cancer cells from androgen dependent to androgen independent state. In addition, we have also briefly introduced an alternative mechanism to explain this complicated transition process.