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Page 63 Oboma et al. J Transl Genet Genom. 2025;9:62-75 https://dx.doi.org/10.20517/jtgg.2024.74

BACKGROUND
Prostate cancer is one of the most common malignancies affecting men worldwide, particularly in older
[1]
populations . According to recent epidemiological studies, prostate cancer ranks as the second most
frequently diagnosed cancer death in men, with its incidence rising significantly in regions such as North
America, Europe, and parts of sub-Saharan Africa. Approximately 1 in 44 men died from prostate cancer,
with a total of 35,250 deaths worldwide in 2024 . The risk factors for prostate cancer include age, family
[1-3]
history, race, lifestyle, and mutation in the BRCA1 and BRCA2 genes. African-American men and
Caribbean men of African descent have been found to present with higher incidence and mortality rates
compared to other races, which is attributed to genetic predispositions and access to healthcare
[3]
disparities . Current treatment strategies for prostate cancer include a combination of surgery,
radiotherapy, chemotherapy, and hormonal therapy, depending on the stage and aggressiveness of the
[1]
disease and the diagnosis of definitive tumor markers . Early-stage prostate cancer can be effectively
managed with surgery or localized radiation; advanced cases present significant therapeutic challenges due
[4]
to metastasis and resistance to conventional therapies and, therefore, the need for more personalized and
innovative approaches to managing the disease. Gene and cell therapies now represent groundbreaking
approaches aimed at overcoming the limitations of conventional cancer treatments, unlike traditional
methods that often target cancer tissues non-specifically. These therapies work at the molecular level,
correcting the underlying genetic mutations or enhancing the immune system’s ability to recognize and
destroy cancer cells. Gene and cell therapy have gained considerable attention due to their potential to
provide long-term remission with fewer side effects . Figure 1 illustrates gene therapy. Regulatory agencies
[5-8]
should prioritize the accelerated approval of clinical trials and products. The article selection method for
this review was based on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) standards. Eighty-four (84) articles from standard electronic databases published in English
between 2018 and 2024 were extracted and reviewed.

CURRENT THERAPEUTIC APPROACHES
Prostate cancer treatment has traditionally relied on well-established modalities, including surgery,
radiotherapy, hormone therapy, and chemotherapy. The choice of treatment is typically guided by the stage
of the cancer, the patient’s age and overall health, and whether the disease has spread beyond the prostate
gland. For early-stage prostate cancer, localized treatments such as radical prostatectomy (surgical removal
of the prostate) and external beam radiotherapy are highly effective in controlling the disease and
improving long-term survival rates . Hormone therapy, also known as androgen deprivation therapy
[9]
(ADT), is commonly used in patients with advanced or metastatic prostate cancer. Prostate cancer cells rely
on androgen to grow. ADT reduces androgen levels or blocks their effects, leading to a significant reduction
[10]
in tumor size and slowing the progression of the disease . Hormone therapy is not curative and may
eventually lead to castration-resistant prostate cancer (CRPC) due to the cancer's negative response to
hormonal manipulation. Chemotherapy was initially reserved for advanced-stage prostate cancer or when
the disease becomes resistant to hormone therapy. However, it has now been extended to non-hormone-
resistant cases. Drugs like docetaxel and cabazitaxel are used to kill rapidly dividing cancer cells but often
[11]
come with severe side effects such as fatigue, hair loss, and weakened immune function . Chemotherapy
has been shown to prolong survival, but it does not offer a cure and is associated with significant toxicity.

Despite the effectiveness of these standard treatments, they come with notable limitations. Surgical
interventions, though potentially curative in early-stage disease, carry risks such as urinary incontinence,
erectile dysfunction, neuropathy, and other complications that significantly affect a patient’s quality of
life . The availability of da Vinci and other robotic systems in Uganda and other African countries has
[12]