Biological behavior of prostate cancer is uncertain. The disease develops for several years and widely is asymptomatic and diagnosed on autopsies. The incidence of prostate cancer rise with male age. Modern diagnostic methods and a wide public knowledge on the disease natural history lead to an active case finding policy. It brought a shift on disease staging toward early stage at diagnosis. Without doubt in several cases an overdiagnosis is made. Approximately 25 - 40 % of patients with potentially curable disease experience a progression after therapy with curative intent. The allocation of patients in different risk groups based on prognostic factors seems to be crucial for the advice on adequate therapy. The use of nomograms helps taking decision on this issue. PSA double time (PSADT) seems to have the power to advice on whether aggressive treatment is useful. Several treatment opinions are taking in account based on disease stage. The role of neoadjuvant and adjuvant medicamentation with radical therapy is critically discussed. Critical recommendations are made regarding antiandrogen monotherapy in advanced prostate cancer. Benefits and efficacy of maximal androgen blockade in metastatic disease were reviewed. Early versus delayed hormonal manipulation after diagnosis or disease progression were considerate based on a available relevant literature.