Volume 15 Issue 7, July 2018

Metastatic prostate cancer has traditionally been treated with systemic therapy alone, but the issue of oligometastatic disease raises the question of whether local therapy — radical prostatectomy or prostate radiotherapy — should be performed. A number of phase III trials should improve our understanding of metastatic disease and lead to better care of our patients.

The role of 5α-reductase inhibitors (5-ARI) in prostate cancer chemoprevention remains a controversy, as cancer prevention trials with 5-ARIs have shown a decreased incidence of low-grade prostate cancer but a potential increased risk in high-grade disease. Recent studies have shed light on the long-term safety of 5-ARIs in terms of influencing prostate cancer risk.

In this Review, Berish and colleagues outline the development of currently used models of prostate cancer bone metastasis and discuss mechanistic and therapeutic advances made using these models. The authors also suggest future directions to improve the applicability of these models to the metastatic cascade and human disease.

Social media offer varied opportunities for education and networking for patients with prostate cancer and health-care professionals, as well as potential uses in research, advocacy, and awareness campaigns. In this Review, leaders in the field discuss social media in prostate cancer and consider the obstacles and potential for their use in the future.

Joosten et al. review the main epigenetic alterations involved in renal carcinogenesis and their effects on key signalling pathways. The authors also discuss the utility of epigenetic aberrations as renal cancer biomarkers and their potential as treatment targets.

Active surveillance protocols rely on the premise that low-risk disease remains indolent. Thus, understanding environmental factors that promote the progression of indolent disease towards aggressive stages is important to manage men on these programmes. In this Perspectives, the authors describe the data regarding the roles of dietary calcium and vitamin D in prostate cancer and consider whether intake should be modified in men with the disease.