Genetic evidence from at least 10 prostate cancer cohorts on inheritance of the adrenal-permissive HSD3B1(1245C) allele demonstrates that increased metabolic flux through 3βHSD1 hastens androgen biosynthesis, progression to CRPC, and prostate cancer mortality (12, 13, 35–38). This evidence concerns the gene HSD3B1 and Familial prostate cancer.