Prostate Cancer

Why won't my doctor test my PSA after 4 years of asking?

Last week I asked my doctor for the 3rd time why he never tested my PSA !!! That was 4 yrs ago when PSA tests weren’t recommended!!! His answer to why !!! We are all going to die. !!!!!!!!!!

What are prostate cancer treatment options and experiences?

I was recently diagnosed with prostate cancer and learned about my treatment options. My doctor explained that I have several choices ranging from active surveillance (closely monitoring the cancer without immediate treatment) to more active treatments like surgery and radiation therapy. Active surveillance would help me avoid treatment side effects right now, while surgery and radiation aim to eliminate the cancer but may come with side effects to discuss with my care team. I'd love to connect with others who have faced similar treatment decisions and hear about your experiences. • If you chose active surveillance, what has that journey been like for you? • For those who went with surgery or radiation, what helped you decide and what should I expect?

Should I delay radiation treatment for urinary retention issues?

Now I can’t find a question I posted here yesterday. I expected this site would be like a support group of cancer survivors who are highly informed about treatments, side-effects, options, etc., but it seems more like a social media thread with members, including myself, commenting with half-backed opinions instead of info based on either formal research or “lived experience”. In the end, I asked my chat-bot, who reassured me that there are several treatments for my urinary retention and discomfort, other than the options of either delaying my 3rd radiation treatment or risking cathetitization: My chat-bot’s reply: You're on session 2 of 5 radiation treatments and experiencing acute urinary symptoms—frequency, mild dysuria, weak stream. You're concerned about urinary retention and possible catheterization. What you're describing is classic acute radiation cystitis/prostatitis. The radiation causes inflammation and edema of the prostate and bladder neck, compressing the urethra. This is expected, but the severity matters. Regarding your specific question—should you request a delay if your oncologist doesn't suggest it? Yes, you should raise it proactively. Trickling stream after only 2 sessions suggests significant inflammatory response; likely to worsen with sessions 3-5. Risk of retention: Complete obstruction is a real possibility; catheterization under these conditions is uncomfortable and risks infection. Treatment/timing: A brief pause (3-7 days) for anti-inflammatory therapy may allow continuation without compromising cancer control. Your priorities: You value work capacity; severe urinary symptoms + possible catheterization would disrupt this more than a short delay What to ask your oncologist: 1. "Given my progressive urinary obstruction symptoms after 2 sessions, should we pause for anti-inflammatory treatment before session 3?" 2. "Would a short delay compromise my cancer control, or can we make up the dose?" 3. "Can we start alpha-blockers (tamsulosin) now to relax the bladder neck and prostate?" 4. "If I develop retention, do you place a catheter, or would you consider a suprapubic tube to avoid urethral trauma?" What they may offer without delay: • Alpha-blockers (tamsulosin/Flomax): Relax smooth muscle, improve flow • Anti-inflammatories (NSAIDs or corticosteroids): Reduce edema • Urinary analgesics (phenazopyridine/Azo): Symptom relief When delay is clearly indicated: • Rising post-void residual volumes • Complete or near-complete retention • Inability to tolerate fluids (dehydration worsens symptoms paradoxically) My assessment: Request the conversation. A proactive pause is preferable to emergency intervention. Your Decipher 0.75 and high-risk status justify completing treatment, but not at the cost of preventable complications.

Should I continue active surveillance or pursue treatment for prostate cancer?

I have been diagnosed for prostate cancer four years ago in April 2022. My Urologist placed me on Active Surveillance since then. I have received a biopsy each year since 2022 These have been done by first having an MRI of the pelvic area followed by a biopsy using an Ultrasound. 12 or 14 samples taken each time with an Oncologist's evaluation. Two of the five biopsies I've had resulted in a positive result for cancer cells being present. The first one (2022) and the last one three weeks ago (2026). Additionally, my doctor sent the samples each time to a lab in CA to determine if the type of cells were aggressive or slow acting. In my case they are of the slow acting variety cells. My question is as a healthy 73 year old, do I continue on the course of Active Surveillance, or advocate for a more substantive treatment, such as radiation or radical prostatectomy. The idea of having this cancer thing inside of me is undermining my mental tranquillity and that of my family. I am concerned that I may need the surgery at some later time and I won't be healthy enough to survive it.

Have you taken germline/somatic testing for cancer genes?

Has anybody taken germline/somatic testing? If you have tested positive for additional cancer genes,what would be the next course of action?

What to expect when stopping abiraterone for a new clinical trial?

Hello James..with a recent full body scan at the finish of a clinical trial (pluvicto) I am now moving to 2nd clinical trial which is all hormone based...to qualify for this new trial I'm being taken off abiritorone and prednisone... I am all in to get ready for this next trial and I will report back on its progress.. getting back to answering your question The prednisone and abiritorone treatment was keeping the cancer progress in check.. I've been on that since May 2024 and it is time to move into a new chapter of recovery.. Thank you for your response and I will keep in touch

What's it like taking abiraterone and prednisone for prostate cancer?

I have stage IV prostate cancer and my doctor has prescribed abiraterone acetate with prednisone. From what I understand, this medication blocks testosterone production since prostate cancer cells use testosterone to grow and spread. My care team mentioned they'll be monitoring me closely with regular blood tests to watch for side effects like high blood pressure, liver problems, and electrolyte imbalances. I'd love to connect with others who have been on this treatment combination and hear about your experiences. • What did your day-to-day routine look like while on abiraterone and prednisone? • What tips or strategies helped you manage any side effects you experienced?

What's it like taking abiraterone and prednisone for prostate cancer?

I have stage IV prostate cancer and my doctor has prescribed abiraterone acetate with prednisone. From what I understand, this medication blocks testosterone production since prostate cancer cells use testosterone to grow and spread. My care team mentioned they'll be monitoring me closely with regular blood tests to watch for side effects like high blood pressure, liver problems, and electrolyte imbalances. I'd love to connect with others who have been on this treatment combination and hear about your experiences. • What did your day-to-day routine look like while on abiraterone and prednisone? • What tips or strategies helped you manage any side effects you experienced?

Should I choose surgery or radiation for Grade 2 Gleason 7 prostate cancer?

I was recently diagnosed with Grade 2 Gleason 7 (3+4) and provided 2 option, surgery or radiation both have pros and cons and would like to hear from people who had one or the other to understand issues or problems you encountered. Also would like to hear if you had one and wish you chose the other one.

What are the side effects doctors don't tell prostate cancer patients?

If you receive a diagnosis of prostate cancer (PCa), you need to know all of the pros and cons of treatment alternatives. But many doctors aren't good at telling PCa patients about the negative side effects of the more invasive or aggressive treatments, such as prostatectomy, radiation, and androgen deprivation. Fortunately, they ARE good at telling other doctors about the drawbacks of these interventions, via articles in professional medical journals and in the urological and oncological press. Here are a few of the many examples I’ve encountered: > Diseases 2025, 13(6), 167 — "The lack of specificity in diagnostic tools results in false positives, leading to unnecessary interventions. … Moreover, economic incentives and the availability of advanced diagnostic technologies further drive overuse. Psychological factors, including fear and anxiety, also play a role in opting for aggressive treatments." > N Engl J Med 2023;388:1547-1558, 11-03-23 — "Active monitoring of prostate cancer has the same high survival rates after 15 years as radiotherapy or surgery. … The negative impacts of radiotherapy and surgery on urinary and sexual function persist … for up to 12 years." > J Clin Oncology, Vol 42, No 4_supp 2024 — "Studies have shown that Gleason scores from biopsies match those from removed prostates only about 45% of the time. This discrepancy means that many men may be undergoing unnecessary surgeries based on inaccurate initial assessments." > J Clin Med, Jan23 — "More than 80% of patients present with localized disease, of these, 15% are at high risk for biochemical recurrence, estimated to be 70% in 5 years. … this group also has … mortality related to prostate cancer with ~85% dying within 10 years. … Most are offered radiotherapy with hormonal therapy, an inadequate … approach associated with significant adverse effects." > Medscape, 11/2023 — "Radiation therapy [has] higher risk of persistent fecal urgency and incontinence of gas, secondary malignancy, and hemorrhagic cystitis. A systematic review of … radiation therapy … was associated with increased odds for a second malignancy of the bladder, colon, and rectum." > World J Mens Health. 2023 Jan;41(1): 129-141 — "… most recoveries to the castrate level happen in the first 2 years, with a minimal increase in recovery at 3 years, and almost no recovery after 36 months. Moreover … more than 25% remain castrated." > SMSNA for Patients, 5/2019 — "But even two years after ADT ends, patients may still struggle with low testosterone … linked to lower bone density, leaving men at higher risk for osteoporosis. Men with low testosterone are also more likely to develop diabetes and heart disease. There are sexual side effects … diminished libido, orgasm difficulties, and erectile dysfunction." > ZERO Prostate Cancer: Hormone Therapy, 2023 — “… some cancer cells grow independently of testosterone and remain unaffected by treatment. … For this reason, hormone therapy can't stop cancer." > BOTTOM LINE: When I was diagnosed with PCa in August 2023, I assumed that doctors would tell me the bad along with the good. Wrong. A full and frank PCa education is a PCa patient’s job.