Traditional Chinese medicine in prostate cancer: Exploring pharmacological effects and mechanisms as a novel therapeutic dimension

Prostate cancer (PCa) is a leading malignancy among men worldwide, characterized by the uncontrolled proliferation of malignant prostate cells. Despite advancements in surgical and radiation therapies, androgen deprivation therapy (ADT) remains the primary treatment for advanced PCa. However, treatment resistance often leads to castration-resistant prostate cancer (CRPC), which poses significant therapeutic challenges. Traditional Chinese Medicine (TCM) has been explored as a potential adjunct therapy for PCa due to its multi-targeted approach, enhancing immune response and mitigating drug resistance. This study investigates the molecular mechanisms of PCa progression and the therapeutic potential of TCM formulations in PCa management. A thorough literature search was performed across multiple databases, including PubMed, Scopus, Google Scholar, and Web of Science. Articles published between 2000 and 2024 were screened based on relevant keywords such as "Traditional Chinese Medicine," "formulations," “Extracts”, "bioactive compounds," "prostate cancer," "molecular mechanisms," and "metastasis." From an initial collection of 220 articles, 164 were deemed relevant for inclusion. Chemical structures and mechanistic pathways were illustrated using ChemDraw software, adhering to established guidelines and utilizing structural data from the PubChem database. PCa progression is primarily driven by androgen receptor (AR) signaling, with aberrations in oncogenic pathways such as PI3K/Akt/mTOR contributing to tumor proliferation. TCM-derived compounds demonstrated significant anti-PCa activity by inducing apoptosis, proliferation, and cell cycle arrest. Moreover, TCM formulations exhibited the potential to suppress PCa progression and overcome drug resistance in CRPC models. Clinical studies indicated improved survival outcomes and reduced adverse effects when TCM was combined with standard therapies. The findings suggest that TCM offers a promising complementary approach to PCa management by targeting multiple oncogenic pathways and reducing treatment-related side effects. However, further clinical trials are necessary to validate these therapeutic effects and establish standardized formulations for integration into modern oncology. Future research should focus on the molecular interactions of TCM with conventional therapies to optimize patient outcomes in PCa treatment.