Prostate cancer is the primary
cancer in males, with increasing global incidence rates making this
malignancy a significant healthcare burden.
Androgens not only promote normal prostate maturity but also influence the development and progression of
prostate cancer. Intriguingly, evidence now suggests endogenous and exogenous oestrogens, in the form of
phytoestrogens, may be equally as relevant as
androgens in
prostate cancer growth. The prostate gland has the molecular mechanisms, catalysed by
steroid sulphatase (STS), to unconjugate and utilise circulating oestrogens. Furthermore, prostate tissue also expresses
enzymes essential for local oestrogen metabolism, including
aromatase (CYP19A1) and 3β- and 17β-hydroxysteroid
dehydrogenases. Increased expression of these
enzymes in malignant prostate tissue compared with normal prostate indicates that oestrogen synthesis is favoured in
malignancy and thus may influence tumour progression. In contrast to previous reviews, here we comprehensively explore the epidemiological and scientific evidence on how oestrogens impact
prostate cancer, particularly focusing on pre-receptor oestrogen metabolism and subsequent molecular action. We analyse how molecular mechanisms and metabolic pathways involved in
androgen and oestrogen synthesis intertwine to alter prostate tissue. Furthermore, we speculate on whether oestrogen receptor status in the prostate affects progression of this
malignancy.