Treatments for prostate cancer (PCa) is rapidly developing. Genetic alterations are being mapped that explain disease progression and treatment resistance. These genetic alterations are used to develop new treatment options at different stages of the disease. In this overview, the genetics of prostate cancer development and progression, which allow for therapeutic interventions at different stages of the disease, is highlighted. Novel findings in overcoming androgen insensitivity and growth signaling inhibition will lead the way toward personalized management of prostate cancer.