In men with localized PCa receiving radiation plus ADT, the choice of hormonal agent mattered in a statistically significant way. Over just 12 months, men treated with LEUPROLIDE experienced significantly greater progression of coronary artery plaque compared with those treated with RELUGOLIX. The increase was driven almost entirely by non-calcified plaque, the form more closely linked to plaque instability and cardiovascular events, rather than by calcified plaque.

The authors’ use of coronary CT angiography to directly visualize atherosclerotic change was of interest. This study certainly does not argue against ADT when it is clinically indicated, but it does make for an interesting conversation around drug selection. For men who require ADT, particularly those with baseline cardiovascular risk, the type of hormonal therapy chosen may influence coronary health within a year, not decades later. That is a distinction worth discussing earlier than later.

Investigators at NYU Langone Health found microplastic particles inside prostate cancer tissue in 90% of men undergoing prostatectomy, with significantly higher concentrations in tumor tissue than in nearby noncancerous prostate tissue. On average, cancerous samples contained roughly two-and-a-half times more plastic by weight. The researchers went to considerable lengths to avoid laboratory contamination, replacing plastic tools with nonplastic alternatives and performing the analyses in clean-room conditions, which strengthens confidence that what they detected was truly within the tissue itself.

This study is not intended to prove causation, and the authors are careful to say so. The sample size was small, and the findings were presented as a preliminary report at the American Society of Clinical Oncology Genitourinary Cancers Symposium. Still, the implications are hard to ignore. Microplastics are already known to accumulate in human organs, and evidence links them to inflammation and vascular disease. Whether these particles actively contribute to prostate carcinogenesis, promote a pro-inflammatory environment or are simply markers of broader environmental exposure remains unknown.

This review tackles one of the most stubborn complications in PCa management: our inability to identify bone metastasis early enough to change the trajectory of disease. Despite decades of reliance on PSA, imaging and bone turnover markers, none perform well when the goal is early detection of metastatic skeletal disease. The authors make a compelling case that circulating integrins which are measured through liquid biopsies, may reflect the actual biology of bone spread.

What is especially notable in this paper is the breadth of platforms discussed. Across multiple cohorts, certain integrin signatures were associated with progression, skeletal involvement and mortality, often outperforming conventional markers once metastasis risk was established.

This paper does not claim integrins are ready for routine clinical use tomorrow, but it outlines how they could fill a critical diagnostic gap by identifying men at high risk for bone metastasis before irreversible skeletal events occur. If integrated into existing laboratory pathways integrin-based biomarkers could shift bone metastasis from a late-stage complication to a biologically anticipated (and potentially interceptable) phase of PCa progression.

Reviewing randomized clinical trials published over the past decade, the authors show that diet and nutrition for men receiving androgen deprivation therapy (ADT) are capable of improving metabolic health, fatigue and even quality of life. Mediterranean-style and low-carbohydrate dietary patterns, particularly when paired with exercise, consistently reduced weight gain and mitigated some of the metabolic damage caused by ADT. Importantly, benefits were most apparent when changes were maintained for at least three to six months.

Nutritional supplements such as creatine, whey protein and calcium largely failed to deliver consistent benefits on their own, particularly in conjunction with ADT, while vitamin D showed selective benefit for bone and muscle health. The strongest signal across trials was multidisciplinary care, frequent follow-up, partner involvement and realistic dietary patterns that patients could sustain. In a population where cardiovascular disease, diabetes and fatigue often determine long-term outcomes more than the cancer itself, this paper reinforces that nutrition is not an adjunct to hormone therapy. When done properly, it is part of the therapy.

This large cross-sectional study adds to a growing body of evidence linking metabolic health to prostatic disease, showing that fatty liver disease is a marker of broader systemic risk. In more than 8,500 men aged 40 and older undergoing routine health screening, the presence of fatty liver disease was independently associated with a 21% higher risk of benign prostatic hyperplasia (BPH), even after adjusting for age, PSA, and other metabolic variables. Diabetes carried a similar magnitude of risk. Age and PSA remained the strongest predictors of BPH.

Fatty liver disease reflects insulin resistance, chronic low-grade inflammation and hormonal dysregulation. All of these conditions also drive prostatic enlargement, lower urinary tract symptoms and prostate pathology. Although this study does not establish causality, meaning that fatty liver and diabetes don't cause BPH, it does reinforce that metabolic dysfunction affects other organs.