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Androgen deprivation therapy (ADT) causes a host of well-recognized side effects. Recent epidemiological and clinical evidence suggests that ADT may also be associated with dementia and cognitive impairment. Potential physiological explanations for these observations include altered neuron growth and axonal regeneration, increased ß-amyloid protein levels, and exacerbation of cardio-metabolic disease (including but not limited to cerebrovascular disease), all of which may occur in an androgen-deprived state.
Radium-223 is a novel alpha emitting radiopharmaceutical with bone tropism, now FDA approved for men with symptomatic bone-metastatic castration-resistant prostate cancer.  Approval was based on the survival benefit observed in the phase 3 ALSYMPCA trial over best supportive care, which included oral steroids or hormonal therapies, bone anti-resorptive therapy, and palliative radiation.
In an era when all men got radiation or surgery, there was no need for risk stratification. However, as newer options became introduced, risk stratification became essential. Towards that effort, PSA, tumor grade, and stage have been the backbone of prostate cancer risk stratification for over 20 years. However, in an era of active surveillance for low-risk disease and multi-modal therapy for high-risk disease, it is clear that they are often not good enough. 
PSA screening is the backbone of early prostate cancer detection in the United States and increasingly in other parts of the world too. Due to concerns about over-detection and over-treatment of indolent disease (i.e. harms), PSA screening is controversial, despite level 1 evidence that screening vs. no screening can reduce the risk of death from prostate cancer (i.e. benefits).

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