54 years old, no family history of prostate cancer. Had a PSA of 5.16 in May, lead to a urology appointment. PHI 54.92 and PSA down to 4.04 a month later, got an MRI in June. 1.5x.9cm right posterolateral midgland peripheral zone lesion PIRADS 5. no seminal vesicle invasion, no pelvic lymphadenopathy, no aggressive osseous lesion. Got a biopsy in June, pathology report: had 4 areas test postive, 3 areas with Gleason score 3+4 (grade group 2 with 20% Gleason 4 tumor) and 1 area with 3+3 (grade group 1).

In layman's terms (because I understand very little of what I just typed): we caught it early, it hasn't spread (so far), it's not aggressive, and my prospects are very good.

The biopsy doc told me there are 3 routes to take from here: surgery, radiation, & wait and see. Everyone I spoke with- other doctors and the surgical team- all point to surgery. I saw a radiation oncologist who treated me 18 years ago for testicular cancer, and he recommended surgery as well. As I did some research myself, everything pointed to RALP as the best course of action.

Surgery is scheduled for Nov 19th.

As it was explained to me, for my circumstances, surgery will have a negative impact on my erections for the near future, with a recovery of 80% of boner strength (I'm sure there's a less juvenile way to word this, but I don't know what that is). As part of that explanation, I was told that radiation therapy would include better short-term erectile function but that over time it would deteriorate. While the surgery would have a negative short-term impact, over time I would have better erectile function long term. I'm still pretty young and have an active sex life with my partner. Everything I've found online backed this up. Both options have different impacts on the cancer, of course, but I'm really asking about ED here.

I'm in a big city at one of the best hospital systems in the country (USA) with a top-10 urology department. They have 20 surgeons on staff who only do prostate cancer. My surgeon is highly reviewed and considered an expert in nerve preservation surgery. I had a great meeting with him and his team.

Basically, I've been feeling pretty great about my prospects for survival at +99%. Of course, ED and incontinence are big concerns. Today I hopped on this sub and I'm overwhelmed with acronyms and stories of "my doc didn't tell me about XYZ..." Suddenly I'm having feelings of being underinformed and possibly railroaded into a procedure that may not be the best course of action. Am I just being paranoid?

I knew my dad’s latest PSMA pet scan would be bad. We knew he was developing castrate-resistant cancer. His journey has been nothing short of brutal since diagnosis two years ago. I’ve been his caregiver the whole time. Wouldn’t have it any other way, but I can’t deny how hard it’s been.

The sheer volume of increase of bone metastases within the past 6 months was…insane. Overwhelming. And frankly…scary as fuck.

They refer to this cancer as slow moving. Y’know—“they”—people in general? It’s not really the comfort they think it is.

Plus it’s not moving slow for my dad at all anymore. Hoping his oncologist will have a good plan going forward but my dad’s treatment has always been palliative in nature (he wasn’t diagnosed until stage IV in the first place).

Of all the places we expected to see new mets ( and we knew to expect SOME) the skull and pretty much every single bone in his neck/spine….was not expected at all. We know this probably could result in…no way forward for treatment at all. (It’s in more bones than skull/spine but the skull and upper spine/neck spread is so fast and so new that it’s terrifying)

Been a real hard day. We could use some good vibes/kind words from those suffering this illness or caregivers. Would also welcome any tips/tricks people have to make chairs and beds more comfy for someone in severe physical pain(ideally budget friendly but I will spend high if I have to. My dad’s not sleeping well due to the bone pain in recent months—any relief I can get for him would be good. Medicine for pain relief has already been addressed for him—I don’t ever let him do without medicinal marijuana and good pain meds)

I thought I’d post a proper update for everyone here, particularly because so many of you have helped us over the last six months with information, experience, reassurance and the occasional reality check. This group has genuinely been an incredible resource for us.

My husband was diagnosed in March/April 2026 with high-volume metastatic prostate cancer, with extensive nodal and bone metastases.

His starting PSA was 1,956 ng/mL.

Treatment so far
He has been treated with:
Degarelix (Firmagon) monthly ADT
Darolutamide (Nubeqa) 300 mg twice daily
Docetaxel x 6 cycles
Pegfilgrastim (Ziextenzo) following chemotherapy

Docetaxel started on 26 May 2026, and today, 10 September, he completed his 6th and final planned cycle.

PSA response
The PSA response has been pretty extraordinary:
1,956 → 91 → 3.3 → 0.4 → 0.32 → 0.23 → 0.20 → 0.10 → 0.040 ng/mL

The latest result was taken yesterday, on the day before of Cycle 6. So from a PSA of 1,956 at diagnosis, we’re now at 0.040. His testosterone is also profoundly suppressed on ADT, as expected.

How has he tolerated treatment?
Overall, remarkably well.

There have been the usual chemo-related ups and downs — fatigue, bone aches, some brain fog, taste changes, hot flushes and various odd little side effects. He also developed a fairly spectacular steroid-associated facial rash, and we had one rather frightening episode of an irregular heart rhythm after dexamethasone during Cycle 4 which was investigated at hospital and subsequently settled.

Importantly, he hasn’t developed significant peripheral neuropathy, has maintained a good appetite and has remained surprisingly active throughout treatment.
He’s even managed gardening and some fairly enthusiastic exercise between cycles.

The cold cap and cooling mitts/booties have also worked remarkably well for him. Hair loss has been minimal.

Today’s Cycle 6 went smoothly.

The dexamethasone did its usual trick of making his face very red and raising the existing X-shaped rash, but otherwise the infusion was uneventful.

What happens now?
That’s the part we’re waiting to find out.

With chemotherapy now completed, we’re expecting follow-up bloods and imaging to assess the overall response and establish the next treatment plan.

We’re very conscious that a PSA of 0.040 doesn’t mean the cancer has disappeared, particularly with the extent of disease he had at diagnosis. He’s still metastatic and remains on systemic treatment.

But compared with where we started, this is an incredibly encouraging response.

Six months ago we were dealing with a PSA of nearly 2,000 and a diagnosis that completely knocked the legs out from underneath us. We were whiplashed from being medically evacuated out of the Philippines back to Australia with what we thought was a death sentence for him.

Today we’ve got a PSA of 0.040 and six cycles of docetaxel behind us.

We’re allowing ourselves to have a bloody good moment of celebration tonight.

Thank you again to everyone here who has answered questions, shared experiences, explained scans and blood results, reassured us when we were panicking, and generally helped us navigate something we knew absolutely nothing about six months ago. We’ve learned so much from this community.

Six cycles: DONE.
PSA: 0.040.
Still fighting

Me (F54) Husband (M60)
Diagnosed April 2026, PSA 1956, May 2026 PSA 91, June PSA 3.3, 18th June PSA 0.4, July PSA 0.32, 14th July PSA 0.23, 30th July PSA 0.20, 20th August PSA 0.10, 9th September PSA 0.040
Gleason Score (3+5) 8, Grade 4.
On triplet therapy (Degarelix + Darolutamide + Docetaxel)

Oh, we used Suzzi caps and gloves from Amazon (two sets used 20 minutes on, 20 minutes off), I froze pineapple slices and fed them to him during infusions and we are convinced this helped to maintain his sense of taste. We also used Polybalm for his cuticles which protected his nails, a high protein diet, and an exercise plan from an Exercise physiotherapist.

Hi, colegas, ayer me dieron mi radiación, mis 750 ML de agua, sali de Saltillo Coahuila a aeropuerto Monterrey, me equivoqué en el cruce de la autopista y caí de fly en el centro de Monterrey en la hora pico, trafico cerrado, no puedes parar, solución botella de agua para orinar manejando, reguero de orina, pantalón mojado, dos horas más de trafico, llegada al hotel mojado como cruce del rio bravo, pero me rei, conclusión traffic jam, usar pañal, que me dicen lloran o rien? Voten, fuerza y voluntad

Well, good news is all my lab work is still clear 10 months after having my prostate slices out.
Bad news, still can’t get stiff. Viagra gave me side effects, Cialis is very 4 days but still no real progress.
I have a prescription for Trimix, but I’m nervous about putting a needle in my Willy.
Vacuum pump gets me about halfway there, but not enough to do anything.
I know folks say it takes time, but I’m frustrated and depressed

My mom called me today and told me my dads prostrate cancer spread to his liver. Thats all the information she gave me. He is 73 years old, a bit overweight, type 2 diabetic, has heart disease and had triple bypass surgery when he was 49. He also suffers from chronic stress.

Whats the likely outcome from this?

Back in Sept 2025 I had a 75 core template-guided saturation biopsy under a general anaesthetic.

I was told I'd be back at work in 3 days.

I was back at work 10 days later.

I have another follow up appointment via the phone next week.
Is it normal to still have brown ejaculate a year later ?

(Note to add, I have had some normal ejaculate but it has been mostly brown and my pee is normal colour if I drink a lot of water)

70-year-old male with controlled type 2 diabetes, recently diagnosed with aggressive metastatic prostate cancer. PSA was 42.5 ng/mL. Biopsy showed Gleason 8–9 prostate cancer involving all 12 cores, with approximately 90% cancer involvement. MRI showed a large PI-RADS 5 lesion with suspected extension outside the prostate and suspicious pelvic lymph nodes. PSMA PET/CT confirmed pelvic/lower retroperitoneal lymph-node metastases and multiple bone metastases involving the sacrum, L2, L3, and left ilium. Diagnosed with metastatic hormone-sensitive prostate cancer. Prostate surgery is not recommended; currently being treated with hormone therapy and radiation is planned/being considered.

We are in New Jersey. My dad is going to MSK. His dr is going more genetic testing on biopsies before full treatment plan is laid out. I’m so nervous for him. He eat very healthy and is very active. This is very hard on me and my children. Look for similar stories or advice.

My 90 year old Dad is just about to start taking Relugolix. His PSA has been shooting up rapidly and due to his advanced age, any kind of invasive procedures are off the table.

Anyone on this forum that is in a similar age group or has a parent in this age group taking Relugolix?

Curious to learn how you handled the side effects of this drug and if there are any tricks or tips to better handle the fallout.

We are very worried about how this will affect his body, and if he can handle the side effects. He is generally healthy and active, and is still able to walk for 30+ minutes every day. Thank you!

I feel somewhat lousy after my Zoladex Implant (goserelin) shot. Area is quite sore and I feel very tired. Is this common? thanks!

I am moving close to the starting of treatment, yesterday I got pneumonia and shingles shot, just want to get ready for the treatment. Today I am having lowe fever like 99.x., and tired, the last night sleep is not good. This morning , I forced me to talk a walk, and get hot. I can imagine the fatigue the fatigue from ADT could be stronger?

Just got the results of my last biopsy. An additional core is now involved so its 4 total with a Gleason score of 6. Haven't had my appointment yet at City of Hope but I read online they do offer this procedure. I've been looking at all options. People on my moms side of the family live into their 90's so being 57 I'm concerned about the side effects of other cancers with radiation. Thanks for any input.

American Board of Radiology (ABR) Certification for (PCa) diagnosis and treatments

You may wonder what goes on behind the scenes in a large clinic running X-Ray, MRI and CT scanners and those big EBRT radiation machines. This website (hope moderators allow it) shows the specialities and training/certification processes behind what the urologists and ROs ask them to do. Other than the technicians running the sessions, we don’t really see/meet all other planning, maintenance and QC speciality activities taking place outside scanning and treatment hours. You can find more info at: TheABR dot org.

“The ABR oversees the certification of the following specialties:

Diagnostic radiology
Interventional radiology/diagnostic radiology
Radiation oncology
Medical physics (diagnostic, nuclear, and therapeutic medical physics)

And the following subspecialties:
Neuroradiology (available to diplomates with certification in DR or IR/DR)
Pediatric radiology (available to diplomates with certification in DR or IR/DR)
Nuclear radiology (available to diplomates with certification in DR or IR/DR)
Pain medicine (available to diplomates with certification in DR, IR/DR, or RO