Management of Non-metastatic castrate-resistant prostate cancer

When castration resistance is established, it is essential to rule out the presence of metastases or micrometastases by optimizing the use of imaging techniques. If non-metastastic castrate resistant prostate cancer diagnosis is confirmed the physician is in front of a difficult decision: to treat it or not and if not, how he can follow up his patient. In practice, patients awareness of their PSA levels and pressure to act upon any increase of PSA influence management irrespective of physical or radiographic findings. This highlights the need to have more accurate assessment of nmCRPC severity and the risk of progression. We review the literature about this ambiguous entity and we summarize all the available data for it’s management.