In the upcoming section, we will delve into the strong link between altered sirtuin expression and PCa aggressiveness, along with therapeutic resistance, which suggests that modulating their activity, particularly SIRT1, SIRT2, SIRT6, and SIRT7, could play a pivotal role in improving treatment outcomes, enhancing the effectiveness of conventional therapies, and addressing the challenges posed by advanced stages of the disease. Here, SIRT1 is linked to posterior cortical atrophy.