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Upon completion of the chapter, the reader will be able to:

  1. Identify risk factors associated with prostate cancer development.

  2. Discuss the benefits and risks associated with prostate cancer screening.

  3. Appraise the prognostic- and patient-specific data needed to determine appropriate treatment options.

  4. Evaluate pharmacotherapeutic treatment options for patients with localized prostate cancer, metastatic castration-sensitive prostate cancer (mCSPC), nonmetastatic castration-resistant prostate cancer (nmCRPC), and metastatic castration-resistant prostate cancer (mCRPC).

  5. Recognize common adverse effects and formulate a monitoring plan for patients receiving androgen deprivation therapy for prostate cancer based on patient-specific factors and the prescribed regimen.

  6. Recognize the common adverse effects and formulate a monitoring plan for patients receiving treatment for metastatic prostate cancer.

  7. Identify patients who are eligible for targeted treatment with poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors or immune checkpoint inhibitors based on molecular testing results.

  8. Provide recommendations for bone health for patients undergoing treatment for prostate cancer.


image Prostate cancer is the most frequently diagnosed cancer among men in the United States and represents the second leading cause of cancer-related deaths in all men.1 The disease course ranges from indolent, asymptomatic tumors that may not require treatment to rapidly progressing, aggressive tumors that result in distant metastases, morbidity, and mortality.


In the United States alone, it is estimated that 248,530 new cases of prostate cancer will be diagnosed, and more than 34,130 deaths will occur in 2021. Although prostate cancer incidence increased during the late 1980s and early 1990s due to widespread prostate-specific antigen (PSA) screening, prostate cancer–related deaths declined beginning around 2000, but have been stable since 2013.1

Prostate cancer risk factors include age, race/ethnicity, and family history of prostate cancer (Table 92–1).2 Age is the greatest predictor of risk, and while the disease is rare among men under age 40, the incidence sharply increases with each subsequent decade of life.3 An evaluation of autopsies from men who died of unrelated causes revealed prostate cancer in 2%, 29%, 32%, 55%, and 64% of men in their third, fourth, fifth, sixth, and eighth decades of life, respectively.4

Table 92–1Risk Factors Associated With Prostate Cancer

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