Steven Joniau, MD, PhD, University Hospitals Leuven, Leuven, The Netherlands, describes strategies to enhance the detection and stratification of localized and de novo prostate cancer. Whilst genomics can play a role, testing can be prohibitively expensive for healthcare systems and thus cannot be universally implemented. Focusing on targeted biopsies and PSMA PET CT scans may improve the staging of prostate cancer. Despite this, genomic testing is strongly recommended for recurrent and metastatic castration-resistant prostate cancer (mCRPC). This interview took place at the European Association of Urology (EAU) Meeting 2022.