Prostate articles from across Nature Portfolio

Positive surgical margins are an independent risk factor for biochemical recurrence after radical prostatectomy. However, the identification of residual cancer by eye is highly limited, and frozen sections are not always available or possible for all margins. Prostate-specific membrane antigen-targeted fluorescence guidance might close this gap and enhance the surgeon’s eye.

Prostate-specific membrane antigen-PET has become a valuable diagnostic tool. The second version of the Prostate Cancer Molecular Imaging Standardized Evaluation framework is the next step towards a standardized evaluation and reporting system from primary staging to reassessment of advanced prostate cancer.

Transgender women remain at risk of prostate cancer and warrant consideration for PSA screening. However, current PSA reference ranges and guidelines are based on data from cisgender men. As these thresholds might be inappropriate in transgender women receiving gender-affirming hormones, we recommend that these patients should undergo screening for prostate cancer at regular intervals and further evaluation for PSA >1 ng/ml or rising PSA. Furthermore patient-centred dialogues should be initiated with patients to ensure awareness of prostate cancer risk.

High intensity theatre (HIT) lists are an efficient and effective measure to tackle elective surgery backlogs without compromising outcomes and safety compared with traditional elective lists. A recent pilot trial in standard and complex urological surgery at a tertiary hospital in the UK proved successful for both the patients and the staff involved.

Focal ablative therapy has emerged as a treatment option in radio-recurrent prostate cancer to obtain local control of disease and spare patients severe salvage-treatment-related complications. Irreversible electroporation holds the potential to become the standard ablative modality in prostate cancer owing to reliable ablation results, the electricity-based effect and an acceptable adverse-effect profile.