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Prostate cancer is the second leading cause of cancer-related death in Switzerland as well as in other western countries. For patients with advanced disease, ablation of androgens is regarded as optimal first-line treatment. But this treatment is palliative with a median duration of response of about 18 months and hormone refractory prostate cancer remains a challenge. Last year, two large randomised trials demonstrated for the first time a survival benefit with docetaxel based therapy. Additionally, because of better understanding of the biology of hormone refractory prostate cancer a number of new systemic therapies are emerging. To evaluate their usefulness and to make progress in the therapy of this disease, it is essential to enrol prostate cancer patients in clinical trials. Another important issue are bone metastases because they are a significant cause of pain and morbidity in prostate cancer patients. Palliation of pain can be achieved with different means like radiation therapy, radioisotopes, hormonal therapy, chemotherapy, and bisphosphonates. For the optimal treatment of patients with symptomatic advanced prostate cancer a multidisciplinary approach is mandatory.