The use of prostate-specific antigen (PSA) levels as a diagnostic test for prostate cancer has significantly reduced mortality rates, as well as reducing the number of patients diagnosed with metastatic disease. In this video, Francesco Montorsi, MD, of Vita-Salute San Raffaele University, Milan, Italy, explains that even though PSA diagnostic tests have become a vital tool in diagnosing prostate cancer, there are still numerous patients whose cancers progress to metastatic status, or who have high PSA levels and metastatic disease at first consultation. Prof. Montorsi states that in these situations, there is currently no cure aside from delaying disease progression. However, the rise of new therapy options gives reason for optimism in treating this subset of patients. This video was recorded at the 2018 Genitourinary Cancers Symposium, held in San Francisco, CA.