In summary, through the integration of various technical approaches, this study elucidated that OTA technology may promote the development of prostate cancer via the following pathways: endocrine disruption (involving ESR1 and hormone response pathways); the activation of oncogenic signaling (specifically, the PI3K-Akt signaling pathway); metabolic reprogramming (through the AGE-RAGE signaling pathway); and modulation of the tumor microenvironment (including ECM remodeling and collagen signaling). This evidence concerns the gene ESR1 and Familial prostate cancer.