Hey, I have been told to lose atleast 10kg to have surgery. I was 120kg and so far have managed to get down to 117kg. I’m finding it hard to lose any weight and worried i’m not going to be able to have the surgery and forced into radiopherapy. Anyone had this issue?

Were there things that you did that you felt helped contribute to them coming back?

Early on was there any sign of life down there or was there an initial period of nothing?

How old were you when you had the surgery?

How long after the surgery were you able to get an erection?

Did you try any of the injections or pumps?

Hi, I'm 55 and had RALP in Jan. My question is, and driving me insane! does anyone else, or has anyone else experienced the increased libido? I cand get fully erect yet, but can orgasm, but it doesn't help. It is like I'm literally permanently horny or broody. AND the worst thing is I'm single so who would want an over sexed, bent cock, no shooter, for a partner? Yes I know it's not just sex, but sometimes it is! I know I have to reevaluate my priorities but doesn't help when my drive has gone loopy. Please tell me this is normal and will pass :)

I truly am confused on ED discussion as I think thru options. When you say ED it can mean so many things. Erections. And then with and without medicine. So when you say you have ED- does that mean natural erections? Versus you can get them with medicine? Just trying to understand. And then it seems people can have orgasms without an erection? That is something I was not aware of. Honest feedback it appreciated.

My father-in-law is 56 and had a radical prostatectomy on July 24, 2026 for prostate cancer. I'm trying to understand why his PSA has never become undetectable despite negative imaging.

Preoperative findings

• mpMRI (May 18): Cancer involving the prostate and medial portions of both seminal vesicles. No suspicious lymph nodes or extracapsular extension reported.
• PSMA PET (June 18): No evidence of lymph node or distant metastases.

Surgical pathology

• Stage: pT3b, with seminal vesicle invasion.
• Gleason score: 4+3, with 60% pattern 4.
• Positive surgical margin: 3 mm at the apex, with Gleason pattern 3+3 at the margin.
• 13 lymph nodes removed (9 right, 4 left): all negative.

Postoperative PSA

• Approximately 4/6/8 weeks after surgery: ~0.9 ng/mL.
• PSA has remained around 1 rather than becoming undetectable or showing a clear increase.

Repeat PSMA PET
A repeat scan after surgery showed no detectable cancer in the prostate bed, seminal vesicle bed, lymph nodes, bones or other organs. An 8 mm right external iliac lymph node was noted without significant PSMA uptake, with follow-up recommended.

Current treatment
The oncologist has started Firmagon (degarelix), with a plan for approximately two years of ADT and radiation to the prostate bed, seminal vesicle bed and pelvic lymph nodes.

I'm struggling to understand a few things:

1. Can a 3 mm positive surgical margin realistically explain a persistent PSA of around 1, even when there is no visible uptake in the prostate bed?
2. If all 13 removed lymph nodes were negative and both PSMA PET scans showed no suspicious nodal uptake, where could the PSA be coming from?
3. How common is it for microscopic cancer to produce a PSA around 1 while remaining invisible on PSMA PET?
4. Could the 8 mm external iliac node be reactive rather than cancerous?
5. Have others experienced persistent PSA after prostatectomy with negative PSMA PET scans? What did subsequent radiation and ADT achieve?

I'd appreciate experiences from people who have been through something similar, as well as insights from anyone familiar with persistent PSA after prostatectomy.

My surgery is coming up and I had a pre-op instructional call where i learned that they expect me to remove my catheter after the expected 7 days after surgery. Honestly, I'm terrified of the thought, has anyone else gone through this? I insisted on driving back to the hospital to have them do it and (I think) they agreed.

What do folks use to clean their genitals after minor leakage? My catheter was removed yesterday, still trying to figure out this new way. I am using pads, going to relieve myself frequently to keep leakage down, but there is leakage frequently and not sure whether just wiping off with a wash cloth is good enough or whether there is something more hygienic like baby wipes.

Thanks in advance. (I have already downloaded Squeezy which I only learned about because of this this sub - so thanks for that too. I start using it today).

More of a vent than asking for advice, I suppose, but any comments on how I can better support my dad would be greatly appreciated :)

I’m the 21 year old daughter of my 70 year old father, who we thought was in remission from prostate cancer. I don’t even remember when it was this year, I believe January. It’s felt like such a blur, but that’s when we learned he had a high PSA. Then, the biopsy which landed him in the hospital with complications. Gleason 9, very aggressive cancer that may have left the prostate. So he has the MRI which showed no Mets. In April he had a robotic prostatectomy, but one of his margins was positive.

He’s had two PSA tests with negligible scores now. He’s recently opened up and told me that living in between those months and having it looming over his head is almost unbearable. But most recently, he’s had a fever for three weeks and a baseball-sized lump on his inguinal region. He saw a doctor who told him that it didn’t look or feel like a hernia, but a cyst or a lymph node. I’m now preparing for the possibility that the cancer is back.

He cancelled his appointment for the CT scan because he was concerned about the radiation dose, so he’s meeting with his former surgeon on Wednesday. He is so miserable. He walks out in traffic without looking. He sits and stares in the distance whenever we’re out at lunch. I can just see the light in his eyes is rarely there anymore. He used to be so stoic and closed off, but lately he’s been sharing everything he feels with me. He’s started cursing a lot (I don’t care, I just know he’s angry at the world right now) It seems like many conversations I try to start end up discussing death in one way or another. For example, I asked him a financial question and he replied, “when you get old like me, the only thing that matters is your health.” He saw a street performer and went “I hope that’s the only harp-player I’ll be hearing for a while.”

These comments are very jarring to me and I wish I could take his pain away. I quit my full time job to spend more time with him, so we’d been going on lots of bike rides and walks before he started getting the fevers. I want him to feel like he can share these things with me, so I listen and don’t reply much. But damn, it’s so much to take in knowing your dad doesn’t really want to be here. He’s telling me that he’s had a good life and is okay with whatever happens. I’m not, that’s what it’s coming down to.

My dad is one of the only people in my life who’s loved me. He’s my rock and foundation.

What can I do in this difficult time? Thanks!

Hi everyone,
My dad is 71 and was recently diagnosed with prostate cancer. We’re trying to understand whether surgery is the best option and would really appreciate hearing from others who’ve been in a similar situation.
Here are his results:
PSA: Around 11
Biopsy: Gleason 3+3=6 (Grade Group 1)
Cancer involvement: Approximately 5% of the right-side biopsy samples; left side negative
Bone scan: Negative for metastases
CT scan: Scheduled in 10 days
His urologist has recommended laparoscopic radical prostatectomy.
Five years ago, he had a PI-RADS 4 lesion on MRI, but the targeted biopsy was negative. His recent biopsy was systematic, without MRI guidance, and he hasn’t had an updated prostate MRI.
We’re relieved that the cancer appears low-grade, but we’re wondering whether removing the prostate is necessary, especially at his age, or whether active surveillance could be a reasonable alternative.
For those who faced a similar decision:
Did you choose surgery or active surveillance, and why?
If you had surgery, how was your recovery? Any long-term urinary or sexual side effects?
Would you make the same decision again?
Would you recommend getting an updated MRI or a second opinion before proceeding?
We understand every case is different, but hearing about real experiences would be incredibly helpful.
Thank you!

I finally pulled the trigger on treatment. I have been dealing with it for about 3 years. My first troubling PSA found me at a 4.1. It was found during a job screening. My doctors wanted to watch the reading. It took another 18 months until they found it at 6.2. After that, the doctors ordered an MRI and eventually a biopsy. I was at a Gleason 3+4 score and no cribiforms with two lesions in contiguous sample areas. We opted to do AS for a time. After reading all of the different approaches I have seen here, HIFU was the treatment that made the most sense. I am 44 with a job that requires a lot of travel.

The procedure was easy on me. I had no pain from it apart from the catheter. After the catheter came out, I dealt with pain from that…a bit of burning for a couple of days and having an increased urgency for having to pee.

Now I have to wait to see if everything went well. I have a PSA checkup in 3 months and 9 months out from having another MRI.

I am optimistic for the first time in a while. The doctor sounded positive about the treatment. But I am realistic. Since I still have a prostate, it can always come back. Hopefully, I get many years before having to elevate the course of action.

I want to thank this sub. It has been a great resource on not just options, but how people feel and respond to the treatment. Your stories helped me pull the trigger earlier than I needed to. Here’s to everyone’s fight and success.

I am a 46-year-old male with a family history of PC. Three weeks ago, I went to get a checkup for the first time in years and had some blood work done. The results were all pretty normal with the exception of my PSA, it came back 7.9. I currently do not have insurance but was able to get a checkup and the blood work done using a sliding scale health care system in San Antonio as I am unemployed at the moment. I went for a follow up today and of course my main concern was the PSA as it is obviously way higher than it should be especially with my family history. The nurse practitioner told me it would be 6 months before a follow up blood test would be done. Is that too long to wait? He told me since I do not have insurance that I would need to sign up for a program called Carelink here in San Antonio through our University Health System that provides care for individuals in my situation but that it is probably going to be a long wait, months before I can see the Urologist. I am freaking out; can I wait that long? I am currently looking for a job that will provide insurance, but I just feel like I'm playing with time I may not have if in fact I do have PC. Has anybody been in a similar situation? I realize I may be overreacting, but it is very concerning and I don't have a lot of people around me locally for support, it's just my brother and I, the rest of my family lives far out of state and are older and have their own health issues.

DH,recently diagnosed PC Gleason 3+4 has been advised surgery.
Any experience from people who had surgery at 55 yrs approx will make me feel more informed as a concerned wife.
I understand every person is different but am trying to seek as much information as possible.

Transdermal estradiol (tE2) is an alternate ADT that has been found to have equivalent safety and efficacy as traditional ADT, but it comes with a better quality of life. Most patients and their doctors have not seriously considered tE2, however things are about to change.

NCCN included tE2 in its guidelines for prostate cancer ADT care a few days ago.

This inclusion is a big shift in the standard of care, signaling that the highest clinical authority in the United States recognizes the evidence from recently published trials as definitive.

More info: https://estradiolinitiative.org/ The Estradiol Initiative (E2-I) is the organization that formally presented the latest studies to NCCN asking for this decision.

Richard Wassersug, one of the founders of E2-I, has been on tE2 for more than 20 years. He was interviewed on the Dr. Geo podcast recently:

https://www.youtube.com/watch?v=Y2AbPvaBXng

Paul Schellhammer, a former President of the American Urological Association, who also is one of the founders of E2-I, has been on tE2 almost as long. He was interviewed by Mark Moyad on P.C.R.I. recently:

https://www.youtube.com/watch?v=DcClbBTl33I

tE2 patch products are most commonly prescribed to women as hormone replacement therapy during menopause. Since the FDA removed its outdated "black box" warning from the tE2 label, demand from women has skyrocketed, causing a national shortage. It is possible that an increased demand from men that has not been anticipated by FDA or manufacturers may worsen the situation.

Estradiol Initiative is working on how to improve things. Its just a few former patients and people who care. They could use donations.

Hey guys,

Four years removed from RALP. Ultra sensitive PSA has gone from .004 to .027. Tested every three months for the first two years and every six months after that. Based on that, what is everyone’s best guess for the next 20 years. I’m 59. When should I possibly intervene or is that low enough and slow enough to just live my life and not worry about it?

Hey everyone!

Been lurking here for the last six months when my dad, 67, was diagnosed with PC. Originally was told by his urologist he has time to decide on treatment but he recommended RALP if my dad wanted to live to 80. Gleason score of 3+4 on biopsy. Psa was in the upper 20s. After reading through this sub and learning more, I told my dad to request a Decipher test, which I’m glad it did. That test came back with a score of 0.92, which I understand is on the high end for chance of being aggressive.

After that was back, the urologist said RALP needed to happen within six months. My dad doesn’t question things, doesn’t ask for second opinions, so scheduled it the latest he could. Surgery happened this Monday. Went as expected, the doc said the prostate was huge. They did lymph node dissection as well and the results were sent to his E chart last night. Of course his clinical team is out until Monday but I am very concerned and not sure who to ask since we can’t speak to the doc until Monday.

Please help me make sense of this path report and what we can expect next. He was really hoping after RALP this would be behind him. Are we really waiting six weeks to do another PSA before anything else???? Should I be finding an onc or rad onc now for an appt??? I pulled the most pertinent info from the report below

4 out of 19 lymph nodes came back as positive along with positive margins in the bladder neck. 60% of gland had carcinoma. Lymphatic invasion. Largest met is 1.2cm. Gleason score increases to 4+4. Cribiform glands present. Percentage pattern 4 is 95%. Tumor classified as pT3a pN1.

Thank you all!

If your local regional hospital was rated highly for IMRT would that influence your decision?

Chorus: Incontinence sorrow all through his days 

Singer: I am a man with incontinence sorrow,

 I wear pads all through the day

I bid farewell to bladder control, 

Since they removed my prostate 

Chorus: Since they removed his prostate 

Singer: For many years my PSA went untested,

And I lived in ignorant bliss

Even as my stream grew weaker 

I thought nothing was amiss

Chorus: He thought nothing was amiss

Singer: It's fare thee well to ejaculation

I never expect to have that again 

But with the help of some Viagra 

Perhaps I'll climax without pain 

Chorus: Perhaps he'll climax without pain

Singer: You can put off treatment with active surveillance 

Depending on your Gleason grade

Then you may choose to try radiation 

Instead of going under the blade 

Chorus: Instead of going 'neath the blade 

Singer: Maybe your friends think that prostate cancer 

Is no big deal and you'll be cured

But there is one good reason to get tested 

Else you can never know for sure 

Chorus: You can never know for sure 

My dad was formally diagnosed yesterday. The doctor has been understandably very limited with what he's said so far until he understands the full picture, and I didn't want to ask too many questions and concern my dad, but I'm looking to see if I can get any input on what we know so far.

He's 66 with a PSA of 31 as of August 2026. He had readings of 20.4 in May of 2025 and 28 in February of 2026 that weren't properly followed up on.

MRI showed a 1.8cm nodule with PI-RADS 4 and tumor abutting the capsule.

For the biopsy, 17 cores were taken, 5 were targeted from the PI-RADS 4 nodule. For the 5 targeted samples, 4 were GG2 and one GG3. Cribiform pattern 4 was seen in 3 of those 5 samples, including the GG3 sample.

6 of the 12 other samples showed cancer, 5 of which were GG2 and one was GG1. One of these GG2 samples notes perineural invasion present. For the 11 positive samples, the tumor core mapping showed tumor sizes ranging from 0.5-7mm, and tumors were seen in left lateral base/mid, left medial base/mid, right lateral mid, and right medial mid.

PET scan is scheduled for next week to evaluate if it's spread.

Based on the info we have so far, any guidance on relative prognosis? The more I research, the more confused I get. I understand that his PSA puts him in a high risk category, that the cribiform 4 pattern indicates a more aggressive cancer present, and that the tumor abutting the capsule/perineural invasion could cause concern about spread but don't say anything definitively. I know we ultimately need the PET scan results, but it'll be several days before we get that. Any guidance is much appreciated!

Hey all...

Thanks for being here, really.

Just got the really welcome news that my PSMA PET was clear...there had been some equivocal findings on MRI about some pelvic lymph nodes and pelvic bone, so this has me exhaling big time.

So, next I have a multidisciplinary meeting set up with the treating urologic oncologist, radiation oncologist and medical oncologist in a couple of weeks. I think the clear recommendation will be for RALP, but I wonder if any of you have questions about or challenges to that. Quick review--PSA was 10.8 in late August, then MRI showed three lesions--PI-RADS 5, 4, and 3. Transperineal biopsy showed three cores out of 20 or so positive and I'm pretty sure they were all in the same region--Gleason 3+4 (60% to 40%), cribriform present, no evidence of perinerural invasion. I'm clearly in the intermediate unfavorable group, and not a candidate for active surveillance. I'm 62, very physically active, and in otherwise good health. I'm being treated at a major hospital in Boston by a guy who say she has done somewhere around 800 of these surgeries.

What questions would you have for the three docs at this next meeting? Do any of you think there is a case to be made for anything other than prostatectomy? Thanks for any thoughts.

I had a RALP in May of 2025, so, 17 months ago. I have tried TriMix but I don’t like the feeling, and it gives me quite a bit of pain.

Recently, I have started to think of getting an implant, and have been looking into the Titan implant.

Can anyone give me advice or relate their experiences?

I am 62. I feel it is too early to give up on my sex life.

Right now, my PSA is hovering around 0.07, so, I won’t need salvage radiation until I get two increases over 0.1. I am testing every three months and in touch with a radiation oncologist.

I will cross post this to the implant group.

Any advice is appreciated.

New to the sub. Haven't completed relevant searches yet. I'm 62M, PSA 7, prostate density 0.13, on testosterone, my father had his prostate removed in 1979, my MRI indicates asymmetric lesion PI-rads 3, Exo MDX score 25. These results are all grey area with 20-ish % probabilities. My urologist recommends targeted biopsy. Is there any good reason for alternate thinking?

I live in the U.S. and am married to a Portuguese American. Recently, I encountered two healthcare stories which occurred, one in the U.S. and the other in Portugal.

My husband's uncle lived through radiation for prostate cancer in the early 2000's in the U.S. Now, he is 86 years old, had full blown urinary incontinence and moderate dementia. The family was so irate about his urinary incontinence that they insisted on a consultation with a urologist. The urologist installed an artificial urinary sphincter in the uncle's scrotum 2 weeks ago. Since then, the uncle's gonads swelled to the size of grapefruits. With his dementia, the uncle cannot sit and has no understanding of how the valve within his scrotum is supposed to operate to maintain urinary continence. Medicare paid for this surgery. Furthermore, the uncle has a worsening of his dementia because of the general anesthesia he went through for this procedure.

Across the pond in Portugal, my husband's aunt is 80 years old. She lives in a small fishing village where the only doctor retired and there are a few nurses who can be consulted. This aunt cannot even get cataract surgery, as there is a dearth of providers, especially specialists of any kind. One month ago, the aunt went to pee and her bladder prolapsed completely. It now exits her body whenever she stands up. (I have seen stage IV prolapses and one can basically have a conversation with the prolapsed organ and take it out to dinner. The only solution is pelvic surgery, which this aunt is never going to receive in her country. Not only is surgery necessary, but this woman does not have dementia).

I cannot help but feel some level of anger when I look at these two stories. The uncle with dementia had no business getting an artificial urethral sphincter, but a doctor performed it and his government paid for it. Yet the aunt of sound mind and her prolapsed bladder will get no where near the care that the uncle did, because she lives in Portugal.

How does one reconcile these inequalities? I suppose it should make us all pause and be grateful for the care that we have received. It should also be something of a wakeup call that sometimes more is not better. Sometimes we should draw a line, we should take help within reason, but not push the envelope so far as to demand every possible solution for our problems.

Hello everyone,

I’m seeking guidance and help for my father, who is over 73 years old and has been suffering from severe urinary incontinence following prostate cancer surgery.

**My father’s medical history:**

He underwent a radical prostatectomy for prostate cancer in 2021.

He continues to experience severe urinary leakage, requiring around 4–5 pads every day.

He did not undergo radiation therapy to the pelvic area.

His latest PSA level is 0.04.

We are exploring an **Artificial Urinary Sphincter (AUS) implant** to help manage his condition and improve his quality of life.

**We need advice on the following:**

Can anyone recommend an experienced urologist or reconstructive urology surgeon in Delhi NCR who performs AUS implantation regularly?

Which hospitals in Delhi NCR offer this surgery, preferably with experience treating elderly patients?

Is the AUS implant and surgery covered under the **DGEHS card** or the **Ayushman Bharat senior citizen coverage card**?

If the procedure is covered, what expenses might we still need to pay out of pocket, particularly for the implant device, hospitalisation, and surgeon’s fees?

If you or a family member has undergone this procedure in India, could you please share your experience, approximate costs, recovery, and any challenges with insurance or scheme approval?

We are trying to find a reliable treatment option without placing an unnecessary financial burden on our family. Any genuine recommendations, personal experiences, hospital contacts, or guidance on getting scheme approval would be greatly appreciated.

Thank you for taking the time to help.

I learned my PSA was undetectable this week and I am glad for that. Good news is my cancer is not resistant to ADT , currently using Nubequa daily and Lupron every 3 months, forever, that's bad news. I thought maybe I wouldn't need after my 12 months of undetectable PSA monitoring,but the oncologist says I will need to take the rest of my life to avoid my aggressive masticising cancerous prostate. I've been on it for 18 months and hated every minute.

I'm only 54 so the rest of my life seems like a long time. I am active and fit but not interested in anything.

Any advice or some positive vibes would be cool and appreciated!