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It details characteristic morphologic effects of hormonal and radiation therapies across common specimen types and explains how newer ablative modalities can still present evolving histologic consequences. The review highlights diagnostic challenges, including obscured residual carcinoma and compromised Gleason grading, and provides practical guidance for accurate post-treatment evaluation by integrating clinical history when available.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/treatment-related-changes-in-the-prostate-past-present-and-future-therapies/362120/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/treatment-related-changes-in-the-prostate-past-present-and-future-therapies/362120.png","ImageObject",300,407,{"name":92,"@type":93},"Levi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Which prostate cancer therapies are covered in the review?","Question",{"text":112,"@type":113},"The review covers established treatments such as radical prostatectomy, androgen deprivation therapy (ADT), and radiation therapy (RT), as well as emerging focal ablative techniques like cryotherapy, HIFU, photodynamic therapy (PDT), and interstitial laser thermotherapy.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why can post-treatment histology complicate diagnosis?",{"text":117,"@type":113},"Treatment-induced morphologic alterations can obscure residual carcinoma and complicate tumor grading and staging. 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DOI: 10.1111/his.15507  \nREVIEW  \nTreatment-related changes in the prostate: past, present and future therapies  \nKatrina Collins 1 & Liang Cheng2  \n1Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN and 2Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, The Legorreta Cancer Center at Brown University, and Brown University Health, Providence, RI, USA  \nCollins K & Cheng L  \n(2026) Histopathology 88, 40–52. [https://doi.org/10.1111/his.15507](https://doi.org/10.1111/his.15507)  \nTreatment-related changes in the prostate: past, present and future therapies  \nA broad spectrum of therapies is available for the management of prostate cancer, ranging from well-established interventions like radical prostatectomy, androgen deprivation therapy (ADT) and radiation therapy (RT), to emerging modalities such as focal ablative treatments and targeted molecular therapies. These therapies can induce profound histologic alterations in both benign and malignant prostate tissue. Hormonal and radiation therapies are particularly known for their distinctive and often extensive morphologic effects, which have been well documented across needle biopsies, transurethral resection of the prostate (TURP) or enucleation specimens and prostatectomy samples. Novel ablative techniques—including cryotherapy, high-intensity focused ultrasound (HIFU), photodynamic therapy (PDT) and interstitial laser thermotherapy—are gaining traction,  \nyet the histologic consequences of these newer modalities are still being characterized. These treatment-induced changes can obscure residual carcinoma, complicate tumour grading and staging and sometimes render traditional parameters such as Gleason scoring unreliable. As therapies evolve, pathologists must remain informed about the spectrum of post-treatment changes to accurately interpret prostate specimens. Diagnostic accuracy hinges not only on recognizing these morphologic effects but also on integrating clinical history, particularly when treatment details are not readily available. This review provides an overview of current and investigational prostate cancer therapies, their histologic impact and practical guidance for post-treatment evaluation.  \nKeywords: focal therapy Gleason grading, hormonal therapy, post-treatment histology, prostate cancer, radiation therapy  \nAddress for correspondence: K Collins, Department of Pathology, Indiana University School of Medicine, 350 W 11th Street, Indianapolis, IN  \n46202, USA. e-mail: [katcoll@iu.edu](katcoll@iu.edu)  \nAbbreviations: ADT, androgen deprivation therapy; AR, androgen receptor; CAP, College of American Pathologists; CRPC, castration-resistant prostate cancer; DDR, DNA damage repair; DHT, dihydrotestosterone; EBRT, external beam radiation therapy; GUPS, Genitourinary Pathology Society; HIFU, high-intensity focused ultrasound; IHC, immunohistochemistry; IMRT, intensity-modulated radiation therapy; ISUP, International Society of Urological Pathology; LCNEC, large cell neuroendocrine carcinoma; LHRH, luteinizing  \nhormone-releasing hormone; PARP, poly (ADP-ribose) polymerase; PDT, photodynamic therapy; PET, positron emission tomography; PSMA, prostate-specific membrane antigen; RP, radical prostatectomy; RT, radiation therapy; SBRT, stereotactic body radiation therapy; SCNEC, small cell neuroendocrine carcinoma; TURP, transurethral resection of the prostate.  \n􀀁 2025 The Author(s) . Histopathology published by John Wiley & Sons Ltd.  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.  \nTreatment-related changes in the prostate 41  \nIntroduction  \nProstate cancer remains one of ","cbCaitWdjCjC4YyS","https://ap.wps.com/l/cbCaitWdjCjC4YyS","pdf",2580799,13,"English","# Introduction\n# Therapeutic Modalities and their Pathologic Impact\n## Radiation Therapy\n## Types of radiation therapy","[{\"question\":\"Which prostate cancer therapies are covered in the review?\",\"answer\":\"The review covers established treatments such as radical prostatectomy, androgen deprivation therapy (ADT), and radiation therapy (RT), as well as emerging focal ablative techniques like cryotherapy, HIFU, photodynamic therapy (PDT), and interstitial laser thermotherapy.\"},{\"question\":\"Why can post-treatment histology complicate diagnosis?\",\"answer\":\"Treatment-induced morphologic alterations can obscure residual carcinoma and complicate tumor grading and staging. Traditional parameters such as Gleason scoring may become unreliable.\"},{\"question\":\"What helps pathologists improve diagnostic accuracy after treatment?\",\"answer\":\"Diagnostic accuracy depends on recognizing treatment-related morphologic effects and integrating clinical history, particularly when treatment details are not readily available.\"}]","Treatment-related changes in the prostate: past, present and future therapies | PDF",1790146520,33]