Prostate cancer management is experiencing three critical transformations that clinicians should understand. First, the traditional surgery-first paradigm is being challenged by evidence supporting concurrent systemic therapy integration from treatment initiation. Second, perioperative approaches now coordinate systemic therapy with local interventions—whether surgery or radiation—rather than reserving systemic treatments for later stages or recurrence.
Third, these evidence-based shifts have the potential to improve outcomes across all risk categories of prostate cancer patients. This represents a fundamental change in clinical sequencing that could enhance cure rates and survival trajectories. As guidelines evolve to reflect this emerging evidence, oncologists will need to reassess treatment planning protocols and patient counseling strategies to incorporate these perioperative approaches.
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