The nervous system in prostate cancer: A basic science and clinical perspective

Area of Science:

• Uro-oncology
• Cancer Neurobiology

Background:

• Prostate cancer (PCa) is a significant global health concern.
• The nervous system intricately regulates prostate function and PCa development.
• Breakthrough discoveries in axonogenesis and neurogenesis revealed cancer-nerve crosstalk.

Purpose of the Study:

• To provide a comprehensive synthesis of PCa neurobiology.
• To integrate preclinical and clinical perspectives on cancer-nerve interactions.
• To highlight the role of neural signaling in PCa progression and treatment.

Main Methods:

• Review of existing literature on PCa and the nervous system.
• Analysis of preclinical findings on molecular mechanisms of nerve activity.
• Synthesis of clinical data regarding nerve infiltration and prognostic factors.

Main Results:

• Nerve-cancer interactions, including perineural invasion (PNI), impact cancer hallmarks and metastasis.
• Sympathetic and parasympathetic signaling, axon-guidance molecules, and neurotrophins play pivotal roles.
• Neuroendocrine differentiation in advanced PCa contributes to castration resistance.
• Radiological assessment of nerve infiltration is important for treatment planning.
• PNI and nerve density show potential as prognostic factors.

Conclusions:

• Neural mechanisms significantly influence PCa progression, metastasis, and treatment resistance.
• Further evaluation and clinical application of nerve-related prognostic indicators are needed.
• Neural-based therapeutic strategies for PCa, such as beta-blockers, show promise but require further investigation.