All epidemiological data predict an endemic rise of prostate cancer in populations with a high proportion of elderly people, leading to a major health problem. The only way to stem this evolution is early detection in organised random- ised trials. Discussion of this controversial subject is followed by an exhaustive review of the endocrine mechanisms stimulating prostate growth and the promising avenues of future research and treatment. Radical prostatectomy and radiotherapy are presented and analysed. Once patients are past this stage of cure, a wide array of medical treatments are available. Endocrine treatment is the first choice, and the different regimes are reviewed as to their respective advantages and side effects. An entirely new approach to hormone refractory diseases completes this overview.