# Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch

Source: https://onco.cc/roadmaps/prostate-roadmap/  
OnCo record `prostate-roadmap` (Roadmap). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Prostate cancer is where hormone therapy for cancer was invented, in 1941, and where a blood test created an epidemic of diagnoses forty-five years later. This roadmap follows the evidence from castration to the modern androgen receptor drugs, through the screening trials and the argument about overdiagnosis they started, to DNA repair, PSMA and the questions still open in 2032.

## Summary

In 1941 Charles Huggins and Clarence Hodges castrated men with advanced prostate cancer and watched the disease regress. It was the first demonstration that any human cancer depends on a circulating hormone, and it is still the backbone of treatment: every man who starts androgen deprivation is repeating the experiment. What followed was a long argument about how to do the same thing better, and it turned out that castration resistance is not the cancer ignoring the hormone but adapting to live on less of it. Visakorpi found amplified androgen receptor in a third of recurrent tumours in 1995; Chen showed in 2004 that receptor overexpression alone converts sensitive disease to resistant and turns antagonists into agonists; Attard's 2008 phase 1 of abiraterone proved the point in people, and enzalutamide, built to the specification Chen described, followed.

The other half of the story is detection. Stamey described prostate-specific antigen as a marker in 1987 and Catalona made it a screening test in 1991, with the 4.0 threshold still on laboratory reports today. Testing spread through primary care before any trial had asked whether it saved lives. When the trials reported in 2009 they disagreed: ERSPC found a 20 percent reduction in prostate cancer mortality at a cost of 1,410 men screened and 48 extra cancers treated per death prevented, and PLCO found nothing, largely because half its control group was being screened anyway. Welch and Albertsen counted what had happened in the meantime: 1.3 million extra American men diagnosed and about a million treated. The United States task force recommended against screening in 2012 and partly reversed itself in 2018.

Treatment moved in the 2000s and then very fast in the 2010s. Docetaxel in 2004 was the first drug to extend survival in castration-resistant disease; cabazitaxel opened the second line in 2010; abiraterone and enzalutamide moved from post-chemotherapy to pre-chemotherapy and then, through CHAARTED, STAMPEDE, LATITUDE, TITAN, ENZAMET, ARASENS and PEACE-1, to the first day of metastatic diagnosis. The genome was mapped in parallel: the TMPRSS2-ERG fusion in 2005, the TCGA taxonomy and the SU2C metastatic cohort in 2015, and the finding that made the biggest practical difference, DNA repair gene alterations in about a fifth of advanced tumours, with 11.8 percent of men carrying an inherited one whatever their family history. PARP inhibitors followed, and PSMA, a protein on the surface of almost every prostate cancer cell, became first an imaging target and then a way of delivering radiation to it.

What has not been solved is stated plainly in the open problems on the prostate cancer page. Overdiagnosis is real and unquantified to within a factor of thirty. Nobody knows in what order to give the treatments that now exist. Resistance arrives for all of them, and in a minority the cancer stops being prostate cancer in any recognisable sense and becomes neuroendocrine, for which there is nothing. And a disease that mostly affects older men has its biggest remaining mortality gap in the causes of death that are not cancer.

UK and NHS specifics (the National Screening Committee position, NICE technology appraisals and their recommendation numbers, Cancer Drugs Fund status, magnetic resonance imaging and radiotherapy capacity, National Prostate Cancer Audit indicators and trial access) belong on the UK and NHS page for prostate cancer and are not restated here.

## Fields

- Kind: Roadmap
- Status: active
- Last checked: 2026-09-25
- Also known as: Prostate cancer history; Prostate cancer evidence roadmap; History of prostate cancer treatment; Prostate cancer timeline

## Sources

- NCI PDQ: prostate cancer: https://www.cancer.gov/types/prostate
- ESMO guidelines: prostate cancer: https://www.esmo.org/guidelines/esmo-clinical-practice-guidelines-genitourinary-cancers/prostate-cancer
- EAU guidelines: prostate cancer: https://uroweb.org/guidelines/prostate-cancer
- ClinicalTrials.gov NCT06320067: https://clinicaltrials.gov/study/NCT06320067

## Connected records

- roadmaps: [Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs](https://onco.cc/roadmaps/chemotherapy-roadmap/), [ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment](https://onco.cc/roadmaps/ctdna-tests/), [Diagnostics roadmap: stains → gene panels → blood tests that decide treatment](https://onco.cc/roadmaps/diagnostics-roadmap/), [Early detection roadmap: organ screening → blood tests for many cancers](https://onco.cc/roadmaps/early-detection-roadmap/), [Hormonal therapy roadmap: removing the ovaries → tamoxifen → oral degraders switched by a blood test](https://onco.cc/roadmaps/hormonal-therapy-roadmap/), [Immunotherapy roadmap: Coley's toxins → checkpoint inhibitors → engineered immunity](https://onco.cc/roadmaps/immunotherapy-roadmap/), [Molecular imaging roadmap: FDG → PSMA → FAP → antigen and immune PET](https://onco.cc/roadmaps/molecular-imaging-roadmap/), [Radiopharmaceutical roadmap: iodine → lutetium → actinium](https://onco.cc/roadmaps/radiopharma-roadmap/), [Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards](https://onco.cc/roadmaps/survivorship-roadmap/), [Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work](https://onco.cc/roadmaps/surgery-roadmap/), [Targeted therapy roadmap: imatinib → designed for resistance → the undruggable drivers fall](https://onco.cc/roadmaps/targeted-therapy-roadmap/), [Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on](https://onco.cc/roadmaps/trial-modernisation-roadmap/)
- cancers: [Biochemical recurrence of prostate cancer](https://onco.cc/cancers/prostate-bcr/), [Localised prostate cancer, high and very high risk](https://onco.cc/cancers/prostate-high-risk/), [Localised prostate cancer, intermediate risk](https://onco.cc/cancers/prostate-intermediate-risk/), [Localised prostate cancer, very low and low risk](https://onco.cc/cancers/prostate-low-risk/), [Metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-mcrpc/), [Metastatic hormone-sensitive prostate cancer](https://onco.cc/cancers/prostate-mhspc/), [Neuroendocrine and small-cell prostate cancer](https://onco.cc/cancers/prostate-nepc/), [Non-metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-nmcrpc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/), [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/), [Early Detection & Screening](https://onco.cc/fronts/early-detection/), [Hormonal Therapy](https://onco.cc/fronts/hormonal/), [Imaging](https://onco.cc/fronts/imaging/), [Radiopharmaceuticals & Theranostics](https://onco.cc/fronts/radiopharma/), [Surgery & Interventional](https://onco.cc/fronts/surgery/), [Targeted Therapy](https://onco.cc/fronts/targeted-therapy/)
- bottlenecks: [Acquired resistance to every therapy](https://onco.cc/bottlenecks/b-resistance/), [Biomarkers are not validated or standardised](https://onco.cc/bottlenecks/b-biomarker-validation/), [Inherited risk is mostly unidentified](https://onco.cc/bottlenecks/b-hereditary-risk/), [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [No one can predict who responds to immunotherapy](https://onco.cc/bottlenecks/b-immunotherapy-response/), [Overdiagnosis and false alarms](https://onco.cc/bottlenecks/b-overdiagnosis/), [Survivorship and late effects are neglected](https://onco.cc/bottlenecks/b-survivorship/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/), [Trial design, endpoints and cost](https://onco.cc/bottlenecks/b-trial-design/)
- key papers: [[ 177 Lu]Lu-PSMA-617 in patients with PSMA-positive metastatic androgen pathway modulator-naive/sensitive prostate cancer (PSMAddition): a phase 3 randomised, controlled trial](https://onco.cc/key-papers/paper-psmaddition-lancet-2026/), [[ 177 Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial](https://onco.cc/key-papers/paper-therap-lancet-2021/), [177 Lu-PSMA-617 versus a change of androgen receptor pathway inhibitor therapy for taxane-naive patients with progressive metastatic castration-resistant prostate cancer (PSMAfore): a phase 3, randomised, controlled trial](https://onco.cc/key-papers/paper-psmafore-lancet-2024/), [A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer](https://onco.cc/key-papers/paper-hugosson-eur-urol/), [Abiraterone in metastatic prostate cancer without previous chemotherapy](https://onco.cc/key-papers/paper-abiraterone-acetate-prostate-n-engl-j-med-2013/), [Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design](https://onco.cc/key-papers/paper-peace-1-lancet-2022/), [Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial](https://onco.cc/key-papers/paper-stampede-lancet-2016/), [AFFIRM: increased survival with enzalutamide in prostate cancer after chemotherapy](https://onco.cc/key-papers/paper-scher-affirm-enzalutamide-nejm-2012/), [ALSYMPCA: alpha emitter radium-223 and survival in metastatic prostate cancer with bone metastases](https://onco.cc/key-papers/paper-alsympca-radium-223-nejm-2013/), [Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer](https://onco.cc/key-papers/paper-nct02489318-n-engl-j-med-2019/), [AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer](https://onco.cc/key-papers/paper-antonarakis-ar-v7-resistance-nejm-2014/), [ARAMIS: darolutamide in non-metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-aramis-nejm-2019/), [ARASENS: darolutamide added to androgen deprivation and docetaxel in metastatic hormone-sensitive prostate cancer](https://onco.cc/key-papers/paper-arasens-nejm-2022/), [Association of Black race with prostate cancer-specific and other-cause mortality](https://onco.cc/key-papers/paper-dess-black-race-prostate-mortality-jama-oncol-2019/), [CHAARTED: chemohormonal therapy in metastatic hormone-sensitive prostate cancer](https://onco.cc/key-papers/paper-chaarted-nejm-2015/), [Clinical and genomic characterisation of treatment-emergent small-cell neuroendocrine prostate cancer](https://onco.cc/key-papers/paper-aggarwal-t-sccpc-jco-2018/), [COU-AA-301: abiraterone and increased survival in metastatic castration-resistant prostate cancer after docetaxel](https://onco.cc/key-papers/paper-cou-aa-301-abiraterone-de-bono-nejm-2011/), [D'Amico risk groups: biochemical outcome after radical prostatectomy, external beam radiotherapy or brachytherapy](https://onco.cc/key-papers/paper-damico-risk-groups-jama-1998/), [Detection of individual prostate cancer foci via multiparametric magnetic resonance imaging](https://onco.cc/key-papers/paper-johnson-mpmri-individual-foci-eur-urol-2019/), [Diagnostic accuracy of 68Ga-PSMA-11 PET for pelvic nodal metastasis detection prior to radical prostatectomy and pelvic lymph node dissection: a multicenter prospective phase 3 imaging trial](https://onco.cc/key-papers/paper-psma-prerp-hope-jama-oncol-2021/), [Divergent clonal evolution of castration-resistant neuroendocrine prostate cancer](https://onco.cc/key-papers/paper-beltran-nepc-divergent-evolution-nat-med-2016/), [Enzalutamide with Standard First-Line Therapy in Metastatic Prostate Cancer](https://onco.cc/key-papers/paper-enzamet-n-engl-j-med-2019/), [ERSPC: screening and prostate cancer mortality in a randomised European study](https://onco.cc/key-papers/paper-schroder-erspc-screening-mortality-nejm-2009/), [GETUG-AFU 15: androgen deprivation alone or with docetaxel in non-castrate metastatic prostate cancer](https://onco.cc/key-papers/paper-gravis-getug-afu-15-docetaxel-lancet-oncol-2013/), [Huggins and Hodges 1941: the effect of castration, of oestrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate](https://onco.cc/key-papers/paper-huggins-hodges-castration-serum-phosphatases-prostate-1941/), [In vivo amplification of the androgen receptor gene and progression of human prostate cancer](https://onco.cc/key-papers/paper-visakorpi-androgen-receptor-amplification-nat-genet-1995/), [Inherited DNA-repair gene mutations in men with metastatic prostate cancer](https://onco.cc/key-papers/paper-pritchard-inherited-dna-repair-metastatic-prostate-nejm-2016/), [Integrating evolutionary dynamics into treatment of metastatic castrate-resistant prostate cancer](https://onco.cc/key-papers/paper-zhang-nat-commun/), [Integrative genomic profiling of human prostate cancer](https://onco.cc/key-papers/paper-taylor-integrative-genomic-profiling-cancer-cell-2010/), [KEYNOTE-199: pembrolizumab for treatment-refractory metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-antonarakis-keynote-199-pembrolizumab-jco-2020/), [LATITUDE: abiraterone plus prednisone in newly diagnosed high-risk metastatic castration-sensitive prostate cancer](https://onco.cc/key-papers/paper-latitude-nejm-2017/), [Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context](https://onco.cc/key-papers/paper-draisma-lead-time-overdiagnosis-psa-jnci-2009/), [Long-term follow-up of a large active surveillance cohort of patients with prostate cancer (Sunnybrook)](https://onco.cc/key-papers/paper-klotz-active-surveillance-jco-2015/), [Measurement of prostate-specific antigen in serum as a screening test for prostate cancer](https://onco.cc/key-papers/paper-catalona-psa-screening-test-nejm-1991/), [Molecular determinants of resistance to antiandrogen therapy](https://onco.cc/key-papers/paper-chen-androgen-receptor-overexpression-antiandrogen-resistance-nat-med-2004/), [Niraparib and Abiraterone Acetate for Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/key-papers/paper-magnitude-j-clin-oncol-2023/), [Niraparib and abiraterone acetate plus prednisone for HRR-deficient metastatic castration-sensitive prostate cancer: a randomized phase 3 trial](https://onco.cc/key-papers/paper-nct04497844-nat-med-2025/), [Olaparib plus abiraterone versus placebo plus abiraterone in metastatic castration-resistant prostate cancer (PROpel): final prespecified overall survival results of a randomised, double-blind, phase 3 trial](https://onco.cc/key-papers/paper-propel-lancet-oncol-2023/), [Overdiagnosis and overtreatment of prostate cancer](https://onco.cc/key-papers/paper-loeb-overdiagnosis-overtreatment-prostate-eur-urol-2014/), [PARP and Androgen-Signaling Inhibition plus ADT in Metastatic Prostate Cancer](https://onco.cc/key-papers/paper-nct04821622-n-engl-j-med-2026/), [Phase 1 trial of abiraterone acetate confirms that castration-resistant prostate cancer commonly remains hormone driven](https://onco.cc/key-papers/paper-attard-abiraterone-phase-1-cyp17-jco-2008/), [PIVOT: follow-up of prostatectomy versus observation for early prostate cancer](https://onco.cc/key-papers/paper-wilt-pivot-prostatectomy-observation-nejm-2017/), [PLCO: mortality results from a randomised prostate cancer screening trial](https://onco.cc/key-papers/paper-andriole-plco-prostate-screening-nejm-2009/), [PRECISION: MRI-targeted or standard biopsy for prostate cancer diagnosis](https://onco.cc/key-papers/paper-precision-mri-targeted-biopsy-nejm-2018/), [PREVAIL: enzalutamide in metastatic prostate cancer before chemotherapy](https://onco.cc/key-papers/paper-beer-prevail-enzalutamide-nejm-2014/), [PROfound: olaparib for metastatic castration-resistant prostate cancer with homologous recombination repair gene alterations](https://onco.cc/key-papers/paper-profound-nejm-2020/), [PROMIS: diagnostic accuracy of multiparametric MRI and TRUS biopsy in prostate cancer](https://onco.cc/key-papers/paper-ahmed-promis-multiparametric-mri-lancet-2017/), [proPSMA: PSMA PET-CT versus conventional imaging for staging high-risk prostate cancer](https://onco.cc/key-papers/paper-propsma-hofman-lancet-2020/), [Prospective comprehensive genomic profiling of 3,476 primary and metastatic prostate tumours](https://onco.cc/key-papers/paper-chung-comprehensive-genomic-profiling-prostate-jco-po-2019/), [PROSPER: enzalutamide in men with non-metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-prosper-nejm-2018/), [Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening, 1986 to 2005](https://onco.cc/key-papers/paper-welch-albertsen-psa-era-diagnosis-treatment-jnci-2009/), [Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only](https://onco.cc/key-papers/paper-goteborg-2-n-engl-j-med-2022/), [Prostate cancer therapy personalization via multi-modal deep learning on randomized phase III clinical trials](https://onco.cc/key-papers/paper-esteva-npj-digit-med/), [Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate](https://onco.cc/key-papers/paper-stamey-psa-serum-marker-nejm-1987/), [Prostate-Specific Antigen Screening and 15-Year Prostate Cancer Mortality: A Secondary Analysis of the CAP Randomized Clinical Trial](https://onco.cc/key-papers/paper-martin-jama/), [ProtecT: 10-year outcomes after monitoring, surgery or radiotherapy for localised prostate cancer](https://onco.cc/key-papers/paper-protect-nejm-2016/), [ProtecT: fifteen-year outcomes after monitoring, surgery or radiotherapy for prostate cancer](https://onco.cc/key-papers/paper-protect-15-year-nejm-2023/), [Punctuated evolution of prostate cancer genomes](https://onco.cc/key-papers/paper-baca-punctuated-evolution-chromoplexy-cell-2013/), [Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial](https://onco.cc/key-papers/paper-parker-lancet/), [Rb1 and Trp53 cooperate to suppress prostate cancer lineage plasticity, metastasis, and antiandrogen resistance](https://onco.cc/key-papers/paper-ku-science/), [Recurrent fusion of TMPRSS2 and ETS transcription factor genes in prostate cancer](https://onco.cc/key-papers/paper-tomlins-tmprss2-ets-fusion-science-2005/), [RESTORE: bipolar androgen therapy after progression on enzalutamide in metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-teply-restore-bipolar-androgen-therapy-lancet-oncol-2018/), [Sipuleucel-T immunotherapy for castration-resistant prostate cancer](https://onco.cc/key-papers/paper-kantoff-n-engl-j-med/), [SOX2 promotes lineage plasticity and antiandrogen resistance in TP53- and RB1-deficient prostate cancer](https://onco.cc/key-papers/paper-mu-sox2-lineage-plasticity-science-2017/), [SPARTAN: apalutamide for non-metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-spartan-nejm-2018/), [SPCG-4: radical prostatectomy or watchful waiting in prostate cancer, 29-year follow-up](https://onco.cc/key-papers/paper-bill-axelson-spcg-4-29-year-nejm-2018/), [STAMPEDE: adding abiraterone to hormone therapy at diagnosis of advanced prostate cancer](https://onco.cc/key-papers/paper-stampede-abiraterone-nejm-2017/), [STOpCaP: docetaxel or bisphosphonates added to standard of care in hormone-sensitive prostate cancer, a systematic review and meta-analysis](https://onco.cc/key-papers/paper-vale-stopcap-docetaxel-bisphosphonates-lancet-oncol-2016/), [SU2C-PCF: integrative clinical genomics of advanced prostate cancer](https://onco.cc/key-papers/paper-robinson-integrative-clinical-genomics-advanced-prostate-cell-2015/), [SWOG 9346: intermittent versus continuous androgen deprivation in metastatic prostate cancer](https://onco.cc/key-papers/paper-hussain-swog-9346-intermittent-androgen-deprivation-nejm-2013/), [SWOG 9916: docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer](https://onco.cc/key-papers/paper-petrylak-swog-9916-docetaxel-estramustine-nejm-2004/), [Talazoparib plus enzalutamide in men with first-line metastatic castration-resistant prostate cancer (TALAPRO-2): a randomised, placebo-controlled, phase 3 trial](https://onco.cc/key-papers/paper-talapro-2-lancet-2023/), [TAX 327: docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer](https://onco.cc/key-papers/paper-tannock-tax-327-docetaxel-prednisone-nejm-2004/), [TCGA: the molecular taxonomy of primary prostate cancer](https://onco.cc/key-papers/paper-tcga-molecular-taxonomy-primary-prostate-cell-2015/), [The evolutionary history of lethal metastatic prostate cancer](https://onco.cc/key-papers/paper-gundem-evolutionary-history-lethal-metastatic-prostate-nature-2015/), [The mutational landscape of lethal castration-resistant prostate cancer](https://onco.cc/key-papers/paper-grasso-mutational-landscape-lethal-crpc-nature-2012/), [TOPARP-A: DNA-repair defects and olaparib in metastatic prostate cancer](https://onco.cc/key-papers/paper-mateo-toparp-a-olaparib-dna-repair-nejm-2015/), [Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction](https://onco.cc/key-papers/paper-conti-trans-ancestry-gwas-prostate-nat-genet-2021/), [Transdermal oestradiol for androgen suppression in prostate cancer: long-term cardiovascular outcomes from the randomised Prostate Adenocarcinoma Transcutaneous Hormone (PATCH) trial programme](https://onco.cc/key-papers/paper-langley-lancet/), [TRANSFORMER: bipolar androgen therapy versus enzalutamide in asymptomatic metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-denmeade-transformer-bipolar-androgen-therapy-jco-2021/), [TRITON2: rucaparib in men with metastatic castration-resistant prostate cancer harbouring a BRCA1 or BRCA2 alteration](https://onco.cc/key-papers/paper-abida-triton2-rucaparib-brca-jco-2020/), [TRITON3: rucaparib or physician's choice in metastatic castration-resistant prostate cancer](https://onco.cc/key-papers/paper-fizazi-triton3-rucaparib-nejm-2023/), [TROPIC: prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel](https://onco.cc/key-papers/paper-de-bono-tropic-cabazitaxel-lancet-2010/), [USPSTF 2012: screening for prostate cancer, recommendation statement (grade D)](https://onco.cc/key-papers/paper-moyer-uspstf-prostate-screening-ann-intern-med-2012/), [USPSTF 2018: screening for prostate cancer, recommendation statement (grade C at 55 to 69, grade D at 70 and over)](https://onco.cc/key-papers/paper-uspstf-prostate-screening-jama-2018/), [VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer](https://onco.cc/key-papers/paper-vision-nejm-2021/)
- ideas: [A standing platform trial for every major cancer, funded as infrastructure](https://onco.cc/ideas/idea-tr1-standing-platform-per-cancer/), [Automatic germline testing for every cancer type where it changes care](https://onco.cc/ideas/idea-prev-reflex-germline-testing/), [Cardiometabolic screening and treatment for survivors on long-term hormone therapy](https://onco.cc/ideas/idea-acc-cardiometabolic-clinic-hormone-therapy/), [Destroy the truncated androgen receptor that hormone drugs cannot touch](https://onco.cc/ideas/idea-bio1-arv7-degrader/), [Detect tumours changing cell type from RNA in the blood](https://onco.cc/ideas/idea-bio1-cfrna-plasticity-tracking/), [Evolution-guided 'adaptive therapy' dosing tested in randomised phase 2 trials](https://onco.cc/ideas/idea-tr1-adaptive-therapy-randomised-phase-2/), [Judge a prostate screening programme on metastatic presentation, not on incidence or mortality](https://onco.cc/ideas/idea-prostate-metastatic-presentation-as-the-screening-endpoint/), [Mandatory staged registries for new surgical techniques before wide adoption](https://onco.cc/ideas/idea-fund-device-technique-registry/), [MRI-first prostate screening with genetic pre-selection](https://onco.cc/ideas/idea-prev-mri-first-prostate-screening-prs/), [Prostate active surveillance without scheduled biopsies: MRI and blood tests decide](https://onco.cc/ideas/idea-prev-prostate-as-triggered-biopsy/), [PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer](https://onco.cc/ideas/idea-psma-pet-guided-mdt/), [Publish a per-lesion miss rate for every prostate MRI service before it is allowed to guide focal treatment](https://onco.cc/ideas/idea-prostate-per-lesion-mri-audit-before-focal-treatment/), [Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancer](https://onco.cc/ideas/idea-prostate-randomise-the-sequence-not-only-the-drugs/), [Report death from other causes as an outcome of the prostate cancer service, split by deprivation and ethnicity](https://onco.cc/ideas/idea-prostate-other-cause-mortality-as-a-reported-service-outcome/), [Rotate between drugs on a fixed schedule instead of waiting for failure](https://onco.cc/ideas/idea-bio1-alternating-schedules/), [SMART designs to test treatment strategies, not just single drugs](https://onco.cc/ideas/idea-tr1-smart-designs-for-adaptive-strategies/), [Take high-dose testosterone to phase 3, with progression-free survival through the second line as the primary endpoint](https://onco.cc/ideas/idea-prostate-bipolar-androgen-therapy-phase-3-on-pfs2/), [Test every man for DNA repair faults on the day his prostate cancer is found to have spread, not three treatments later](https://onco.cc/ideas/idea-prostate-hrr-testing-at-metastatic-diagnosis/), [Test whether calling Gleason 6 'not cancer' changes what men choose](https://onco.cc/ideas/idea-prev-gleason6-terminology-rct/), [Use a polygenic risk score to set when screening starts](https://onco.cc/ideas/idea-prev-prs-screening-start-age/), [Watch for the cancer changing cell type before the biopsy says neuroendocrine, and act on it](https://onco.cc/ideas/idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine/)

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