The causes of prostate cancer reflect a complex interaction between environmental and genetic factors. Improvement in screening has reduced the incidence of prostate cancer, and risk assessment schemata have enhanced therapy, both for localized disease and for locally recurrent prostate cancer. The use of hormone therapy has been further evaluated, as primary therapy for locally advanced cancers, for lymph node–positive cancers, and for de novo metastatic cancer. Modest inroads have been made in the treatment and understanding of androgen-independent prostate cancer. Advances have been made in the understanding of the risk factors, genetic and environmental, associated with the development and progression of prostate cancer; in screening; and in optimizing therapy for localized, locally recurrent, and advanced disease. This article reviews the most salient observations reported between November 1, 1997 and October 31, 1998.