In this review, we will focus on how β-adrenergic activity, primarily via the β2-adrenergic receptor (ADRB2) and the subsequent cyclic AMP (cAMP) signaling pathway, affects development of aggressive prostate cancer by regulating neuroendocrine differentiation, metastasis, angiogenesis, and apoptosis-resistance. The gene discussed is ADRB2; the disease is prostate cancer.