The interplay of essential and toxic trace elements in prostate cancer: a comprehensive review of risk factors, prevention, and clinical implications.

A Narrative review

Abstract

Background: Prostate cancer (PCa) is the second most frequently diagnosed cancer and one of the leading causes of cancer-related mortality among men worldwide. Its development is influenced by a complex interplay of genetic, hormonal, environmental, lifestyle, and metabolic factors. Increasing evidence suggests that trace elements play a critical role in prostate carcinogenesis, tumor progression, and clinical outcomes.

Objective: To comprehensively review the role of essential and toxic trace elements in prostate cancer, their association with disease risk and progression, and their potential implications in diagnosis, prevention, and treatment.

Methodology: A narrative review of the published literature was conducted using peer-reviewed articles, systematic reviews, meta-analyses, and clinical studies addressing prostate cancer epidemiology, risk factors, trace element biology, diagnostic biomarkers, prevention strategies, and therapeutic implications. Relevant evidence regarding zinc, selenium, copper, cadmium, arsenic, lead, and iron was critically evaluated.

Results: Essential trace elements, particularly zinc and selenium, demonstrate protective effects through antioxidant activity, regulation of cellular proliferation, apoptosis, immune function, and maintenance of genomic stability. Conversely, toxic elements such as cadmium, arsenic, and lead have been associated with increased prostate cancer risk through oxidative stress, DNA damage, inflammation, and disruption of androgen receptor signaling pathways. Elevated copper and iron levels may contribute to tumor growth, angiogenesis, and disease progression. Several sociodemographic, environmental, occupational, and lifestyle factors further influence prostate cancer susceptibility and outcomes. Although trace elements show promise as diagnostic and prognostic biomarkers, current evidence remains inconsistent and requires further validation.

Conclusion: Trace elements play an important role in the pathogenesis and progression of prostate cancer. Maintaining adequate levels of essential trace elements while minimizing exposure to toxic metals may contribute to prostate cancer prevention and improved clinical outcomes. Further prospective studies and mechanistic investigations are required to establish the clinical utility of trace element assessment in prostate cancer diagnosis, risk stratification, and targeted therapy