Prostate cancer

Fresh treatment options along with kinder and more accurate diagnostics promise to improve care.

Gut microbes drive treatment resistance, fresh hope for immunotherapy, and other studies and clinical trials.

Imaging and advanced tissue sampling techniques could supplement or supersede conventional biopsies of the sensitive gland.

Prostate-specific antigen is an established biomarker, but it is flawed. Research into alternatives is starting to get results, but will they reduce mortality?

Advances in the ability to find and treat tumours that have spread around the body are changing the perception of what is possible for people with advanced disease.

Drugs that direct the body’s proteolytic capabilities towards cancer cells might overcome problems of treatment resistance.

Despite success against other cancers, prostate tumours have so far resisted treatment with immunotherapy. But some researchers are persisting with the approach.

Urological oncologist Miguel Ángel Jiménez-Ríos explains how the psychological burden of the disease should change physicians’ approach to treatment and outreach.

Hormonal therapy has helped many people with prostate cancer to live longer, fuller lives, but mounting evidence suggests that the drugs drive or exacerbate cardiovascular problems.

Personalizing cancer treatment doesn’t only mean matching a drug to molecular markers on a tumour — it should also take into account a person’s sexual identity, interests and wishes.

Population-health researcher Joseph Ravenell explains the various origins of racial disparities in prostate cancer outcomes.

Learning about patients’ experience on therapy informs scientists’ use of advanced diagnostic techniques, design of clinical trials, and evaluation of biomarkers.

In this Perspective, the authors discuss the past, present and future of PSA screening for the early detection of aggressive prostate cancer and propose a way forward for the rational use of PSA testing as part of a risk-adapted screening strategy.

Limited information exists regarding the effects of prostate cancer therapies on sexual health outcomes in sexual and gender minority patients. As clinicians, scientists and advocates, understanding these outcomes is imperative in order to enable personalized clinical decision-making and to create a more equitable health system.

Radical prostatectomy is increasingly used as a first-line treatment for patients with high-risk, localized prostate cancer. Here, Wilkins and colleagues highlight the heterogeneous outcomes of these men and discuss the role of this approach in individualized, multimodal prostate cancer therapy.

Prostate cancer is the second most common cancer and one of the leading causes of cancer-associated death in men. This Primer summarizes the epidemiology, mechanisms and diagnosis of prostate cancer, discusses treatment based on disease stage and effects on quality of life, and highlights ongoing and future research areas.

In this Review, the authors discuss the current evidence for the use of prostate-specific membrane antigen (PSMA) PET and whole-body (WB) MRI, consider the evolving use of PSMA PET-derived and WB MRI-derived quantitative biomarkers and make recommendations for future clinical trials of these modalities.