Prostate cancer poses a substantial clinical challenge and accounts for a large proportion of cancer-related deaths worldwide. The therapeutic landscape has undergone a large transformation in the past 5 years, resulting in improved patient outcomes. In this Seminar, we review the pathology, diagnostic strategies, and treatments for prostate cancer. Active surveillance is the preferred treatment option for patients with indolent prostate cancer. For those requiring treatment, local therapies provide effective cancer control. Systemic treatment is essential for advanced and metastatic cases, and a wide range of therapies are now available, including androgen deprivation therapy, chemotherapy, and emerging targeted agents such as lutetium-177-labelled prostate-specific membrane antigen radioligand therapy and PARP inhibitors. Considering toxicity profiles alongside patient preferences is important to facilitating shared decision making. Further research is needed to establish the most effective sequence and combination of treatments for metastatic prostate cancer.
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Fonteyne et al. (2025) studied this question.
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