Prostate cancer patients are mostly seen in older men over 65 years of age and rare under 50 years of age, but the morbidity and mortality rates increase exponentially when they are older than 50 years of age. In Western countries such as Europe and the United States, PCA is mostly the leading cause of morbidity and mortality of malignant tumors in men, while Asia is a low incidence region for PCA, but the incidence of PCA in China has increased significantly in the past 5-10 years. Genetic predisposition is a recognized risk factor. If a first-degree relative (brother or father) has PCA, the risk of the disease increases more than 1-fold, and if ≥2 first-degree relatives have PCA, the relative risk increases 5-11-fold. Reducing the intake of animal fats and increasing the intake of fruits, cereals, vegetables, and green tea may reduce the risk of developing PCA, but further confirmation is needed. Prostate cancer, which also occurs in older men, has similar urinary symptoms to the aforementioned prostate enlargement and may coexist with the corresponding symptoms of metastatic sites in advanced patients. In the Nordic countries such as Sweden, where the rate of autopsy is high, it has been reported that about 20% of elderly patients who died of other causes have hidden PCA lesions, which means that in some patients, PCA may last for the rest of their lives. In the United States, the probability of prostate cancer being diagnosed during life is 17%, but the probability of dying from prostate cancer is only 3%, so I personally like to refer to prostate cancer as “inert cancer”, which is also the reason why we will talk about active surveillance later. This is an important basis for active surveillance as a treatment option, as we will see later. On the other hand, a relatively small percentage of PCA is prone to early metastasis, and bone metastases are relatively common in PCA, and in my clinical experience, it is not uncommon for patients to present with metastatic bone pain as their first symptom. In my clinical experience, it is not uncommon to see patients with metastatic bone pain as the first symptom. Because of the insidious development of prostate cancer, annual screening with serum prostate-specific antigen (PSA) and rectal examinations are recommended in many guidelines for men over 50 years of age, especially for those with urinary discomfort, and further examinations such as prostate ultrasound are required if appropriate. If the PSA is higher than 10ng/ml (especially if there is a continuous upward trend) and/or the examination reveals prostate nodules, a prostate puncture biopsy should be considered. In the diagnostic process, imaging tests such as ultrasound, CT, MRI and bone scan may be used as appropriate, but their role is mainly to assess the morphology of the prostate tumor and its invasion of the surrounding organ tissues, and they are not sufficient to replace the diagnostic “gold standard” of puncture biopsy. The most important thing to remember is that there are two issues that are often asked by patients. The normal reference value is 4ng/ml, but a higher than normal value or even a slightly higher than 10ng/ml does not absolutely mean prostate cancer, and needs to be analyzed in a clinical context. The percentage of the tissue is very small, just like when we are fishing in a pond, you catch ten or eight grass carp out of ten million fish, but it doesn’t mean that there are not one or two carp missed, so it is very necessary to continue the review and follow-up. Depending on the specific puncture results and the absolute value or dynamics of the PSA, the clinician will make a recommendation as to whether and when to repeat the puncture again. After the diagnosis is confirmed, the physician will stage the prostate cancer according to the location, size, pathological features, PSA level, and invasion of surrounding or distant organs, and use this as a basis for evaluating treatment modalities and outcomes. For early stage limited low-risk tumors with long life expectancy (usually more than 10 years), radical prostatectomy or radical radiation therapy is generally advocated. As technology continues to advance, for patients with localized progression or assessed as intermediate to high risk, a combination of therapeutic measures such as radiation, chemotherapy and endocrine therapy often need to be considered before and after surgery, depending on the specific circumstances, although radical treatment modalities may still be a possible option. For many patients and their families, distant metastasis is a topic of conversation, but the treatment of metastatic prostate cancer has some distinctive features. Because most primary prostate cancers depend on androgens for growth, endocrine therapy is currently the primary treatment for advanced prostate cancer. In layman’s terms, endocrine therapy is the “starvation” of prostate cancer cells through androgen removal. It is not uncommon for most patients to be cured by endocrine therapy, with the primary and distant metastatic lesions completely regressing within a period of time. Androgen removal is achieved through the following strategies: (1) suppression of testosterone secretion: surgical or pharmacological debridement (luteinizing hormone-releasing hormone analog, LHRH-A); (2) blocking androgen-receptor binding: application of anti-androgen drugs to competitively block the binding of androgens to androgen receptors on prostate cells. The combination of the two can achieve the maximum androgen blockade. Surgical debridement and pharmacological debridement are basically similar in terms of their therapeutic effects and expected side effects such as feminization, the former removes the testicles “once and for all” and saves money, but is irreversible and may The latter can retain the testicles and help to adjust the treatment side of desex, but the long-term use of drugs to patients bring a certain economic burden, can be said to have advantages and disadvantages. The majority of patients are initially effective with desmoid or combined androgen blockade therapy, but after an average of 14-30 months, almost all patients will progress to desmoid-resistant prostate cancer and will need to be seen for a combination of treatment modifications or radiotherapy. Radical prostatectomy can be considered the highest level of urological surgery. Minimally invasive surgery is being increasingly used for patients, and laparoscopy is still the mainstay in China, while robot-assisted laparoscopy has gradually become the mainstream of radical prostate cancer treatment in Western developed countries such as Europe and the United States. However, for relatively high-risk cases, open surgery is still a necessary option. The main complications after radical prostate cancer surgery include urethral stricture, urinary incontinence and sexual dysfunction, for which patients should be prepared. Close postoperative follow-up is required for patients who have undergone either radical treatment, endocrine therapy or combination therapy such as radiotherapy. The frequency of follow-up is usually every 3 months, and PSA is an important indicator for follow-up. Based on the PSA value and the trend of change, the doctor will add corresponding auxiliary tests as appropriate, assess possible disease progression or recurrence, and take corresponding treatment countermeasures.