New prostate cancer treatments: key physician takeaways

Prostate cancer remains a significant global health challenge, impacting millions of men each year.

In 2022, more than 1.4 million new cases were reported worldwide,¹ with projections estimating 313,780 new diagnoses in the United States by 2025.² In the UK, prostate cancer accounts for 28% of all new cancer cases in males, with approximately 1 in 8 men being diagnosed over their lifetime.³

As one Sermo member specializing in oncology put it: “Prostate cancer is the #2 cancer killer in men. We need to do something.⁴” This highlights the urgent need for effective prevention, treatment and awareness initiatives.In this article, we delve into the treatments currently used, as mentioned by doctors inside Sermo’s free physician-only community, and explore the latest advancements shaping the future of prostate cancer care.

What current treatments do physicians on Sermo use?

Physicians on Sermo constantly refine their approaches to provide personalized, effective care. Below, we explore their insights and real-world applications.

Hormonal therapy (Androgen Deprivation Therapy – ADT)

Hormonal therapy is a first-line treatment for metastatic and advanced prostate cancer, often combined with other therapies to enhance its effectiveness. By suppressing testosterone production, ADT slows cancer progression while alleviating symptoms.

A case of a 75–year–old male with metastatic prostate cancer highlights its importance.⁵ A Sermo member and physician working in clinical oncology recommended: “Given that he has a stage 4 disease now, I’d recommend starting ADT.⁶” This showcases ADT as the backbone of systemic control in advanced disease.

For more targeted management, another clinical oncology physician suggested combining ADT with SBRT (stereotactic body radiation therapy): “Hormonal therapy Lupron, Casodex, SBRT to a single lesion in lungs.⁶” This approach integrates systemic and localized therapies for better outcomes.

Similarly, in a case of a 62–year–old male with rising PSA levels and a suspicious L2 vertebral lesion,⁷ a hematology member recommended a careful diagnostic and therapeutic balance: “I’d biopsy L2 lesion and start ADT; if biopsy negative, would continue to monitor PSA.⁸”

Sermo members agree: hormonal therapy remains a cornerstone of prostate cancer treatment, offering versatility as both a standalone and combination therapy.

Radiation therapy

Radiation therapy plays a vital role in localized and oligometastatic prostate cancer. Advances like SBRT allow precise targeting of lesions while minimizing side effects.⁹

For the earlier mentioned 75–year–old male with a single metastatic lung lesion, a Sermo Radiation Oncology member emphasized the value of precision imaging: “Consider choline or PSMA PET. If true oligometastatic disease, you could hold off ADT and offer metastatic-directed treatment, i.e., surgery or SABR [SBRT], to spare him toxicities from hormones.”

This sentiment was echoed by another Sermo member and physician in clinical oncology: “I agree with starting with choline PET first and then if truly only lesion, treat with surgery or SBRT.⁶” 

Radiation therapy, especially SBRT, still allows for precise, localized treatment, making it a key option for oligometastatic disease.

PARP inhibitors for BRCA-mutated mCRPC

Genetic testing has unlocked new options for patients with BRCA mutations.¹⁰ PARP inhibitors like olaparib and rucaparib target specific genetic vulnerabilities,¹¹ offering significant benefits.

As noted in a Sermo discussion: “The FDA has now approved several members of the PARP inhibitor class of drugs for treating BRCA-mutated mCRPC…Olaparib combination reduced the risk of disease progression or death by 76% versus abiraterone alone.¹²”

PARP inhibitors exemplify the potential of precision medicine, transforming care for BRCA-mutated prostate cancer.

What are the new prostate cancer treatments in 2025?

The treatment landscape for prostate cancer is advancing rapidly, with several innovative therapies recently approved or under review. Below, we explore the most significant new developments in prostate cancer treatment, framed through real-world cases and insights from Sermo members.

Enzalutamide: a versatile option for hormone-sensitive prostate cancer

In June 2024, the European Medicines Agency (EMA) approved enzalutamide (Xtandi) as a monotherapy or in combination with androgen deprivation therapy (ADT) for patients with high-risk, non-metastatic, hormone-sensitive prostate cancer (nmHSPC) who are unsuitable for salvage radiotherapy.¹³ This approval underscores enzalutamide’s role in expanding treatment options for earlier-stage, high-risk patients.

A case of an 83–year–old male with metastatic castration-resistant prostate cancer (CRPC) highlights the versatility of enzalutamide. After progression on multiple therapies, the patient declined chemotherapy due to concerns about alopecia. 

An oncologist on Sermo shared their approach: “I’d propose enzalutamide or radium-223, perhaps the best choice is radium, reserving enzalutamide for further progression, possibly extraosseous.¹⁴” This demonstrates how enzalutamide can be a vital tool for patients who prioritize quality of life while requiring effective disease control.

Sermo members believe enzalutamide offers flexibility, providing options for both early-stage hormone-sensitive cases and advanced CRPC, tailored to individual patient needs and preferences.

Olaparib and PARP inhibitors: a precision medicine breakthrough

The EMA has also approved olaparib (Lynparza) in combination with abiraterone and prednisone for metastatic CRPC in patients for whom chemotherapy isn’t clinically indicated. This approval builds on the growing evidence for PARP inhibitors in treating BRCA-mutated cancers, an area where prostate cancer treatment is catching up with advancements in breast and ovarian cancer.¹⁵

Approximately 10% of men with metastatic CRPC harbor BRCA1 or BRCA2 mutations, which often correlate with aggressive disease and poorer outcomes.¹² A Sermo discussion emphasized the transformative potential of PARP inhibitors: “The FDA has now approved several members of the PARP inhibitor class of drugs for treating BRCA-mutated mCRPC… Olaparib combination reduced the risk of disease progression or death by 76 percent versus abiraterone alone.¹²”

Sermo members agree that precision medicine is reshaping prostate cancer care, with PARP inhibitors offering targeted solutions for patients with specific genetic mutations, improving outcomes for those who previously had limited options.

What’s the latest treatment for advanced prostate cancer? Lutetium-177 PSMA therapy

Lutetium-177 PSMA therapy is gaining recognition as a promising option for patients with progressive, metastatic CRPC. Approved by the EMA in late 2022, it represents a significant innovation for patients with extensive bone metastases who have exhausted other treatments.¹⁶

A case discussed on Sermo illustrates its impact. A 76–year–old male with CRPC, who’d progressed through multiple therapies, received Lutetium-177 as a last resort. As one oncology physician noted: “Lutetium-177 PSMA therapy…has been a therapeutic novelty with good results in bone metastases.¹⁷”

Another family medicine doctor emphasized: “Lutetium treatment isn’t a standard treatment, but there are patients who benefit. Treatment should be personalized.¹⁷” In this patient, Lutetium-177 relieved bone pain and reduced tumor size, significantly improving quality of life.

In general, Sermo members believe that Lutetium-177 is one of the latest prostate cancer treatments to offer a novel and effective option for managing the condition, particularly for patients with refractory disease and significant bone involvement.

How do physicians balance treatments with patient quality of life?

For physicians supporting prostate cancer patients, balancing effective treatment with quality of life is a complex challenge. 

When surveyed, 68% of Sermo physicians indicated that regaining control of the disease is their top priority when selecting neoadjuvant therapies, while 18% emphasized improving quality of life and 11% focused on addressing treatment resistance.¹⁸

So, what trade-offs must physicians navigate when trying to meet both clinical goals and patient-centered outcomes?

Patient autonomy vs. public education when treating public figures

King Charles’ decision to publicly share aspects of his cancer diagnosis¹⁹ serves as an example of how transparency can foster education while respecting personal boundaries.

An oncologist on Sermo suggested: “In my opinion, a good option is for His Majesty to give later an interview about all these aspects and to emphasize the importance of early diagnosis.²⁰” 

Open communication about cancer can alleviate stigma and reduce speculation, but only when aligned with the patient’s comfort. 

A doctor in Infectious Diseases noted: “The King should just say what type of cancer he has.²⁰” While this could prevent misinformation, it highlights the tension between public expectations and a patient’s need for privacy. 

Striking this balance is essential to safeguard mental health while promoting public understanding.

Balancing aggressiveness with lifestyle preservation

Cancer treatment can sometimes prioritize efficacy over the patient’s day-to-day well-being.

A family medicine doctor on Sermo shared the story of a patient whose overlapping treatments for two cancers may have contributed to a fatal heart attack: “Suspected the radiation likely played a role in her MI.²⁰”

This underscores the importance of ensuring treatments don’t compromise overall health or quality of life.

Your takeaway

Prostate cancer treatments are advancing rapidly, offering innovative options like PARP inhibitors, Lutetium-177 and enzalutamide. However, balancing treatment efficacy with patient quality of life remains essential. 

By tailoring therapies, promoting early detection and respecting patient autonomy, physicians can improve outcomes while ensuring treatments align with individual needs and priorities.

Join the conversation on Sermo

Prostate cancer care is evolving, and staying ahead requires collaboration and shared expertise from physicians worldwide. Sermo allows you to connect with peers, contribute your voice to discussions on important medical topics, and learn from the real-world experiences of other physicians. 

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