Major changes in the field of prostate cancer over the last 25 years include the implementation of prostate specific antigen screening and the recognition that BRCA confers hereditary risk of prostate cancer. Quality of life and survivorship have driven risk stratification for localized prostate cancer, facilitated by molecular signatures and leading to increased acceptance of active surveillance as a mainstream treatment option. Advances in technology have improved efficacy and reduced toxicity in both radical prostatectomy and radiation therapy for localized prostate cancer. Improved understanding of the androgen receptor has yielded substantially more effective therapies. Future growth areas include personalized treatment based on genomic and genetic information, theranostics radiopharmaceuticals, and more aggressive treatment of metastatic disease to include focal therapy. Multidisciplinary management between specialized urologists, radiation oncologists, and medical oncologists remains central to maximizing patient outcomes.

在过去的 25 年中，前列腺癌领域的主要变化包括实施前列腺特异性抗原筛查和认识到 BRCA 赋予前列腺癌的遗传风险。生活质量和生存率推动了局部前列腺癌的风险分层，这得益于分子特征的促进，并导致人们越来越多地接受主动监测作为主流治疗选择。技术进步提高了根治性前列腺切除术和局部前列腺癌放射治疗的疗效并降低了毒性。对雄激素受体的深入了解已经产生了更有效的治疗方法。未来的增长领域包括基于基因组和遗传信息的个性化治疗、治疗诊断学、放射性药物、以及对转移性疾病进行更积极的治疗，包括局部治疗。专业泌尿科医生、放射肿瘤科医生和内科肿瘤科医生之间的多学科管理仍然是最大限度地提高患者治疗效果的核心。