Results from a recent survey of 100 urologists and 100 oncologists who treat patients with castration-resistant prostate cancer (CRPC) identified a lack of physician confidence in choosing among the variety of new anticancer therapies available, and incorporating these therapies into their clinical decision-making process. In response to a survey conducted by Urologic Oncology, a physician roundtable discussion was convened and this companion summary article created to provide a knowledge-based perspective for optimizing CRPC treatment and improving communication between urologists and oncologists (http://prostatecancer.urologiconcology.org/). The participating experts described the importance of a documented testosterone level, despite androgen-deprivation therapy, and an increase in prostate-specific antigen level when diagnosing patients with CRPC. Recently published data and personal clinical experience in CRPC management using approved chemotherapeutics, immunotherapies, and oral agents were discussed, as were management of bone metastases and the overall survival improvement in patients undergoing treatment.