Best of 2022 in prostate cancer and prostatic diseases

Prostate cancer (PCa) is the most common cancer among men. In 2020, 1,414,259 men were diagnosed with PCa, and 375,304 died of PCa. Primary prevention in PCa has always been challenging, considering that the three main risk factors (age, ethnicity, and family history) are non-modifiable. Several authors have explored the role of lifestyle, diet, and physical activity on PCa incidence. However, the results are still controversial. To date, no specific recommendation on lifestyle or diet can reduce the risk of developing PCa. New androgen pathway targeting agents (ARTA) has significantly changed the outcome of metastatic castration-resistant PCa (mCRPC) patients. ARTAs initially used to manage mCRPC patients are approved in different PCa settings, such as non-metastatic CRPC and metastatic hormone-naïve PCa. They are also under investigation in non-metastatic patients as adjuvant and neo-adjuvant treatments. Although these treatments have completely changed the treatment landscape in metastatic and CRPC management, several unmet needs remain. Mainly, mechanisms of resistance, the role of next-generation imaging, optimal therapeutic sequencing, accessibility, costs, the part of patients’ preferences, and clinician experience is still far to be defined.