Recently, licensed and emerging treatments for metastatic castrate-resistant prostate cancer are transforming the prognosis for men whose disease has already progressed during or after docetaxel-based chemotherapy. Two agents (cabazitaxel and abiraterone) are already accessible to prescribers, having shown survival benefits versus their comparators in randomized controlled trials, and other agents are showing promising results. A future in which metastatic castrate-resistant prostate cancer can be managed as a 'chronic disease' looks tantalizingly close. The challenge for clinicians will be to use these treatments rationally, in a way that optimizes each individual patient's chances of prolonged survival.