The PSA era is over. Modern research has shown that it leads to overdiagnosis and overtreatment and far too many surgeries, radiation therapy, and hormonal therapy. Prostate cancer is very common, but only about 2% need to be treated. Preventive measures and environmental toxins are reviewed. The relationship of various hormones is discussed.New tools for diagnosis and treatment are offered reviewed. We don't have good tests to assess the extent or even presence of prostate cancer let alone its degree of malignancy. Unfortunately screening and diagnostic testing for prostate cancer is inadequate and creates a lot of fear over having low grade cancers that are not serious. PSA testing should be reserved primarily to follow prostate cancer patients. Specialized testing with MRI, spectroscopy, and sonography is discussed.