The statistics for prostate cancer make alarming reading and set undoubted challenges for oncological research. In the Western world, where the incidence is highest, a man has a 10–11% chance of developing clinically apparent prostate cancer, and a 3–4% chance of dying from the disease [1]. Worldwide the incidence of prostate cancer is rising annually by 2–3% [2]. In 1986 a quarter of a million cases of prostate cancer were diagnosed and at least half a million cases were expected by the turn of the last century [2,3]. In many countries prostate cancer is now the second leading cause of cancer-related death [4] and in Northern Europe it has already taken number one position as the leading cause of cancer-related death in males [4]. The incidence has increased recently, largely due to better and earlier detection, but also because of the general aging of the world’s population and hence an increase in the proportion of men aged over 65 years old in whom the disease is known to be prevalent. In the USA, although signs are that the rate of increase in incidence is falling slightly, it is predicted that in the next 50 years the number of deaths from this disease could increase by 50% [5]. Translated into actual figures these statistics mean that, in the USA in 1999, there were an estimated 179,300 new cases and 37,000 deaths [6]. Similarly, in Europe, assuming that age-specific rates of prostate cancer remain at 1980 levels, the number of men aged over 65 years with prostate cancer is expected to rise from 79,453 in 1990 to 92,240 in 2000. The rise will be most pronounced in those countries with the greatest increase in life expectancy – France, Germany and Spain – and will be further exacerbated as the post-war ‘baby-boomers’ reach their fifties [5].

Despite its high incidence, knowledge and understanding of the pathophysiology of prostate cancer remains rudimentary. A clearer understanding of the biological nature of the disease could have a real impact on its management. Much progress has been made towards understanding the development and progression of prostate cancer and the factors, which drive the development of androgen independence.