25-year perspective on prostate cancer: Conquering frontiers and understanding tumor biology.

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.

Urologic oncology. 2021 Jul 12 [Epub ahead of print]

Tanya B Dorff, Brock O'Neil, Karen E Hoffman, Daniel W Lin, Kevin R Loughlin, Marc Dall'Era

Department of Medical Oncology, City of Hope Comprehensive Cancer Center. Duarte, CA. Electronic address: ., Department of Urology, University of Utah Huntsman Comprehensive Cancer Center. Salt Lake City, UT., Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center. Houston, TX., Department of Urology, University of Washington, Seattle Cancer Care Alliance. Seattle, WA., Vascular biology research laboratory, Boston Children's Hospital. Boston, MA., Department of Urology, University of California Davis Comprehensive Cancer Center. Davis, CA.

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