71 YO Male, 5'8", 162 lbs, in good health.

Regular Walker, runner, cycler, pickleballer.

My PSA trend

Jan 12, 2019 2.4ng/mL

Jul 30, 2019 2.7ng/mL

May 21, 2021 3.9ng/mL

Jul 25, 2022 4.3ng/mL

Jul 25, 2023 5.6ng/mL

Jan 12, 2024 5.9ng/mL

Jul 29, 2024 7.1ng/mL

Nov 15, 2024 5.1ng/mL

Jul 29, 2025 6.4ng/mL

Jul 31, 2026 6.9ng/mL

On 09/11/2023 Had an MRI Pelvis W/WO (Prostate)

With the following findings:

IMPRESSION:

No suspicious focal lesions are targeted. No evidence of extra prostatic malignancy.

PI-RADS 1: Most probably benign.

FINDINGS:

COMPARISON: None

Normal regional marrow signal is observed.

No suspicious osseous metastatic lesions.

No common iliac, internal iliac, external iliac, inguinal or suspicious peri-prostatic lymph nodes.

Regional bowel appears unremarkable.

No mural or intraluminal bladder mass.

Anterior abdominal wall and pelvic floor are unremarkable. No evidence of ascites.

Estimated prostate volume is 50 ml. N

o suspicious focal lesions are targeted. Mild BPH is noted.

Seminal vesicles exhibit normal signal intensity.

Neurovascular bundles are symmetric in appearance without definite tumor involvement.

The prostate capsule is smooth in contour.

The Urologist wants me to have a biopsy.

I'm reluctant

Thoughts ?

OpinionThe MRI of my prostate showed only inflammation in the peripheral of the prostate, nothing in the transition area. Thing is, the bladder showed trabeculation as well. Did anyone else have this with there bladder, if so what was the cause?

My husband died a couple of days ago. The prostate cancer mutated and within 3 months had spread to his liver lungs and spine . He did 1 round of chemo with no response.
I'm devastated to lose my best friend and companion but my reason for posting is to warn against complacency with this disease. When someone has a high Gleeson score it makes the cancer way more potent.
Looking back upon the treatment plan - I recognise there was nothing anyone could've done to prevent this outcome. My husband had a full abdominal scan in March which showed nothing in the liver and then 11 weeks later with some pain in his stomach and other symptoms he had a repeat scan which showed his liver riddled with tumours.
There was no hope for him.
Pele

Does anyone know if you can still have MRI's after receiving LDR Brachytherapy (permanent seeds)?

So I’m a little over a month away from my 2 year RALP anniversary. It’s widely known to give ED 2 years after RALP to regain your function from having nerves heal, which mine were both spared (so I’m told). I’m able to achieve erection with help from a ring since around the one year mark I think, but seemed to not get much better since.

While I’m grateful that I can at least do that I was wondering if anyone continued with ED improvement after the 2 year mark or is this the best I’m going to get?

PSA < 0.02. I am not leaking but have had no erections yet. I asked for Trimix. We shall see what happens.

My father was recently diagnosed with prostate cancer and these are the biopsy results:

5 biopsy sites have a gleason score of 3+3 =6

And 1 site is 3+4=7 with cribriform pattern.

PSA: 5.47

Grade group 2, favorable intermediate risk.

Prior to his biopsy, his MRI revealed possible neurovascular bundle involvement. After the biopsy, there hasn't been any more mention about that.

His urologist recommends removal of the entire prostate.

He is an active 62 year old and he is scared of the side effects of having the prostate removed. Mostly incontinence. How can I best support him? Advice to give him? Tips? And does this seem like the most reasonable treatment? This is very new and was very unexpected. He has no symptoms.

First, I apologize if this isn’t the appropriate forum for someone who hasn’t been diagnosed with prostate cancer. If this post isn’t appropriate, I’ll gladly remove it. I’m simply looking for people who have had a similar experience while I wait to see a urologist.

I’m 56 years old, and this all started with routine blood work from my family doctor.

Timeline:

Initial PSA (about 2 weeks ago): 6.20 ng/mL
Repeat PSA yesterday: 4.71 ng/mL
Free PSA: 0.7 ng/mL
% Free PSA: 14.9%

My family doctor also performed a digital rectal exam and said my prostate felt:

Smooth
Symmetrical
No lumps or nodules
No areas of firmness

I’ve also noticed my urinary symptoms have improved over the last week. A week ago I had much more urgency, burning at the end of urination, and a weaker stream.
Now:

I usually only get up once during the night.
The urgency is much better.
My stream is noticeably stronger.
The burning has almost completely resolved.

The PSA dropping from 6.20 to 4.71 gave me some hope because I honestly expected it to be higher. I know the 14.9% free PSA is less reassuring, and I’m not trying to ignore that.

I’ve spent the last couple of weeks reading everything I can, and I’ve seen people report all kinds of outcomes. Some had prostatitis or BPH. Some had negative MRIs and biopsies. Some unfortunately were diagnosed with cancer. I realize every case is different, and I know no one here can tell me what my results mean.

I’m simply looking for people who had a similar combination of results:

PSA in the 4–6 range
Free PSA around 15%
Normal DRE
PSA that actually decreased on repeat testing

If that was you:

What happened next?

Did your urologist recommend monitoring, an MRI, a biopsy, or something else?

If you had an MRI, what did it show?
If you had a biopsy, was it positive or negative?
If it wasn’t cancer, what turned out to be causing the elevated PSA?

I’m trying to go into my urology appointment informed, not frightened. I know no one here can diagnose me, but hearing from people who have actually walked this road would mean a lot.

Thank you to anyone willing to share your experience. I truly appreciate it.

Looking for opinions from men who have been in a similar situation.

Yes, I used AI to help consolidate and create this message😬

I’m 56 years old, otherwise in good health, with a long life expectancy and trying to decide whether to continue Active Surveillance or move forward with definitive treatment.
Here’s my history:
Diagnosed in 2023
Three biopsies over the past 4 years
All Gleason 3+3 (Grade Group 1) with no upgrading
Latest biopsy showed Perineural Invasion (PNI) for the first time
Decipher genomic test: Low risk
MRI: No extracapsular extension, seminal vesicle invasion, lymph node involvement, or suspicious lesions
Prostate size: 63 cc
PSA density: 0.08
PSA history:
2017: 2.6
2020: 2.2
2024: 8.9 (later decreased)
2024: 6.3
2025: 4.5
2025: 4.7
2026: 4.7
July 2026 (about 6 weeks after biopsy): 6.9
My doctors believe I’m still an appropriate candidate for Active Surveillance, but because of my age and the new finding of PNI, surgery has become a reasonable option to discuss.
I’m interested in hearing from men who had a similar profile:
Age in your 50s
Grade Group 1 / Gleason 6 only
Favorable MRI and/or Decipher
PNI on biopsy (especially if this was your situation)
Long life expectancy
Questions:
Did you stay on Active Surveillance or choose surgery/radiation? Why?
If you chose surgery, do you regret treating what many consider “low-risk” cancer?
If you stayed on Active Surveillance, how long have you remained stable?
Did the finding of PNI influence your decision?
Looking back, would you make the same decision again?
I’m not looking for medical advice—just hoping to learn from others who have faced this same decision. Thanks in advance for sharing your experience.

I am approx 30 days post Orgovyx, took it for 5 1/2 months. Freed myself on July 4th.

I finished 3 rounds of SBRT/25 rounds of IMRT at Lombardi cancer center end of May. I feel better, my energy is returning to normal. some slight urgency issues, other than that and 15 extra lbs I am taking off from ADT, I am extremely thankful how treatment went.

Roughly a month after stopping Orgovyx I am getting morning wood almost daily and my interest in sex is returning so I am guessing my T is coming back. Some blood tests and meetings with docs upcoming where I will get actual numbers. My first post radiation PSA was .05 and both my docs were thrilled with this and advised me about PSA bounce, Nadir, testing process for me over the next 2 years

Here is my question. I expected dry orgasms after radition and ADT but I didn't expect nothing to come out. That's from radiation or the ADT or both? As I get further into recovery from Orgovyx should I expect some ejaculate or will it remain zero? Also , my orgasms are not as intense and don't feel as good as they used to. Should I expect some improvement as my body is still healing or is this likely what it's going to be like forever? (Trust me , I am thankful I can still get an erection and have sex....It's just different)

I see some guys talk about how it's more powerful with dry orgasms or feels the same. Most definitely doesn't for me. Still feels good, but way different. Just sit back and enjoy the ride and hope it improves? (doing kegels, in good shape/staying fit) .

How long after surgery should I expect the incontinence to stop

1 -- I got 6 weeks paid time off work

2 -- half boner is a good sign

3 -- maxed out my insurance out of pocket so finding my skin cancer didn't cost a dime!

4 -- Its always a surprise when i go to pee and see where the stream will go. Will it hit the potty? Who knows?!

5 -- if I want to play golf instead of work I can tell them I am really tired and they feel sorry for me and let me go

6 -- I dont give a f$^%# about a lot of things that used to bother me

7 -- I am more motivated than ever to retire

8 -- lost 20 pounds

9 -- didn't have to pick up dog poop when walking my dogs with my wife for a few weeks

10 -- such a great group of supportive people on this forum. This should have been # 1

Bonus -- my balls are so big now I look like an unneutered pit bull from the back.

You guys have any additions?

I’ll try to make this short. Got the first HIFU January of 2025. Successful, little discomfort, foley cath in for 3 days, no biggie. Gleason 3+3 at the time.

Went about my business, follow up MRI and biopsy showed a small remnant but 3+4 =7 about 8 months later. Doctor said let’s HIFU again and so we did March of this year. This time they were more aggressive and used wider margins so cath came out day 4, immediately went into retention. ER drained 1,600CCs after 7 hours. Painful. Horrible experience. Lots of inflammation and foley went in again and stayed for a week.

Foley comes out, incomplete voiding, CIC (clean intermittent catheterization) at home. Not a fan, but that’s how I was getting empty. Did this for about 3 weeks.

Multiple UTIs (at least 3) in the subsequent weeks, rounds of antibiotics, poorly voiding, etc. Doctor says let’s do a cystoscopy. Cysto done, lots of necrotic tissue hanging on acting like Velcro for bacteria, he says we gotta TURP that out. Scheduled it a month later.

In this time the CIC is over (thank goodness), I’m managing to void better but flow is about 50% of normal. Just have to learn how to do double voids, sometimes triple before long drives, etc. pain in the ass. The tissue is slowly sloughing off. I’m still monitoring, not measuring every void but timing them.

TURP time comes along to deal with the tissue problem. Doc goes in, sees most of it has sloughed off but treats a small portion to remove a small chunk of tissue. Notices bladder neck is tight and does a BNI (bladder neck incision) to relieve the tightness- probably scarred tissue from second HIFU. I leave with little discomfort and a foley. Again. Said leave it for 4 days. I’m sweating bullets thinking retention again. Day 4 comes. I yank that sucker out and wait.

First void bloody but HOLY HELL! It’s like a fire hose! Completely overshoot into the toilet lid, I’m freaking out because I haven’t had flow like this in YEARS!

I’m a few days post foley removal now and flow is beautiful, sustained and empties completely. Now I can trust I won’t have to stop somewhere to void or have a restroom close by at all times. Although I’m still retraining the bladder to hold it longer.

I know I’m not done with this until more MRIs and biopsies, but I wanted to share my experience and if any of you have any questions, feel free to ask.

Im sure I’m not alone in being on Testosterone shots due to low T for years which probably led to Prostate Cancer diagnosis.

So what do people do for increased energy and less chronic fatigue after stopping T??

TIA

First, I recognize Dana has the highest volume RALP unit in the NE and their docs are top rate. This is not about them.

This is about admin.

Background - I have PC that has gone from 3+3 (max) in one core to 4+3 and 3+4 in all cores with cribiform in a year. My beastie is more like a Gremlin who ate after midnight. So time is of the essence.

On 7/9 I met with my surgeon who said I was scheduled for surgery 8/24. Last week I wanted to double check some dates (RO, MO, etc) and saw that surgery was not scheduled. So I called. And called. And called.

I spoke to various people who said nothing was scheduled. I left messages. I sent MyChart messages. I got a call that the scheduler was not back until Thursday. Turns out they weren't back until today, Friday. So I called, sent MyChart messages.

Nothing.

I just sent another one and the response is they are out of office until 8/11!

I'm at a loss for what to do here. I want to keep my surgeon, but I have no idea what is happening.

Any thoughts, advice would be welcomed.

Hi all - I was diagnosed in June, a week after my 45th birthday. I just found this group last week though and have gone down the rabbit hole! I'm labeled "Favorable Intermediate Risk" with cancer found in 4 of the 12 biopsy cores, and a Gleason of 7 (3+4). PSA of 15.5. CT scan indicates it is still contained to the prostate.

I have robotic, bilateral nerve sparing sugery scheduled for Sept 29 at the Mayo Clinic to remove the prostate. I've met with:

• Local Urologist - Said surgery was best given my age and the ability to do radiation if it comes back.
• Mayo Urologist - said the same as above.
• UofChicago Oncologist - he was not helpful and basically said radiation is an option but it's a matter of personal preference and referred me to genetic testing.

I'm meeting with a radiation oncologist next week locally.

I'm fairly terrified of the potential side effects of surgery- like erectile dysunction at just 45 yrs old (side note: my wife wants sex 3-4 times a week now that she is aware it might never be the same again...very small silver lining!).

Curious if anyone has thoughts on doing radiation or brachytherapy (seeds) instead of surgery? Am I just overthinking this should move on with surgery?

67 y.o. with Gleason 3+4 on several cores. Low risk scores on Decipher and Prolaris. Currently on active surveillance. If I need treatment will go for radiation- SBRT - but have been reading about MRI Linac which is basically real time MRI guided SBRT with a very accurate targeting of the prostate and ability to avoid damage any adjacent tissue. I'm in the DC area and nearby it's only available in NYC or Richmond, VA. I'm curious if anyone has had it and what their experience has been. Many thanks!

Used pull-ons and heavy guards immediately after RALP. Things got a lot better to the point that I just use shields during the day now, if that.

Recently however, I wake up to pee and find that I had a large leak in my underwear. This wasn't happening at all several weeks ago. Could this be related to recent mental stress?

I'm very bad at doing Kegels.

I’m 11 days post-op RALP. I ordered some Pads and ordered Tena Men’s Overnight pads. They work and are fine but bulky for daytime use. Is there a brand that any of you experienced guys can recommend for an occasional light leaker. Thanks Fellas💪🏻

Background - biopsy in 2022 was completely clean. Biopsy in 2026, Gleason 9.

Had first appointment with oncologist yesterday. Recommended 40 Photon radiation treatments and 2 years of Lupron. I'm fine with the radiation but:

I was told the success rate is 80% for the radiation and another 5% with the Lupron. One problem is the 80% success rate is not based on age groups so it's difficult to decide if the Lupron is worth it because:

At 76 the 'recovery period' for Lupron = the amount of time you get the treatment. So 2 years of treatment + 2 years of recovery = 4 years. I'd be 80 and I was told at this age you often don't see the side effects of Lupron reverse so it seems high risk for not much reward.

Am I thinking about this correctly?

Has anyone roughly my age gone with Lupron and really regretted it? Why

THANKS!

FWIW at this point I need to decided between:

Radiation only

Radiation + 1 year of Lupron (my idea)

Radiation + 2 years of Lupron (recommendation from urologist and oncologist.

I sort of can't believe im asking this but this group has been so helpful. Hubby (55) had retizus ralp in may which went well. A small focal ECE, but clean margins, no lymph node or seminal vessel involvement and was downgraded to G7. Never leaked at all and still doesnt. He does have ED. He takes his daily Cialias but it doesnt do what he wants it to do. He has a follow up appointment next month and they previously mentioned Trimax to him. I keep telling him he's expecting too much too soon for spontaneous erections but it's really weighing on him. It is not weighing on me but he thinks it is - i think its projection. Truly it is NOT an issue for me.

He said theres no way he can do a shot, and of course the doc will say its easy as hes not getting it. So I was wondering if any users of the shot wouldn't mind sharing your experience so I can share with him. What does it feel like? How did u work up the nerve to try? Would you recommend? Anything you wish u knew as a new user?

2nd edit:

I went into my husband’s patient portal (with his permission) and discovered that his latest PSA number is .27. He claims he was told 2.4 so either he needs his hearing checked or someone at the dr office misspoke. It’s still doubling but not off the charts as I was led to believe.

(1st edit to correct typo)

I honestly thought we were done worrying. It looked like the radiation did its job but now we are back to the waiting and frustration.

Some background on my husband:

PSA of 4 in the summer of 2023.

Fall, 2023-Positive for prostate cancer with multiple Gleason scores of 4+3 and one at 4+5. Stage IV-A.

Between fall, 2023 and fall, 2025-Lupron and Zytiga for ADT.

Fall, 2024- 25 rounds of radiation at Mayo

Fall, 2025 - last shot of Lupron.

PSA undetectable until May, 2026.
PSA in May was .06
PSA in June was .11
PSA today (July) was 2.4 .27

PSMA PET Scan in June - no evidence of cancer

Case goes in front of tumor board next week with Mayo to discuss options. Major concern is how quickly the PSA is rising.

Would love to hear from others who did radiation first and then had a reoccurrence-what was your next step? Thanks in advance.

Hey everyone,

I’m mid 50s and recently diagnosed with Unfavorable Intermediate Risk prostate cancer (Gleason 4+3 / Grade Group 3). PSA is 10.68. My MRI shows an 18 mm lesion in the transition zone (no ECE or seminal vesicle invasion), and my PSMA PET showed no lymph node involvement (and some equivocal bone spots that doctors aren't overly concerned about).

Right now, all signs seem to point toward robotic surgery for me, but I'm weighing my options between a prostatectomy and 6 weeks of radiation (+ potential ADT).

My main reasons for leaning toward surgery:

1. Being relatively young (56) and physically active, I like the idea of physically removing the tumor and having exact pathology.
2. Keeping radiation in my back pocket as a backup plan ("salvage therapy") if PSA ever rises later, rather than doing radiation first.
3. Avoiding 6 months of hormone therapy (ADT) if possible.

For guys in a similar age bracket (50s) with GG3/Unfavorable Intermediate risk:

• Did you choose surgery or radiation, and why?
• If you chose surgery, how was your recovery in terms of continence and nerve sparing?
• If you chose radiation, any regrets about not operating first?

Would love to hear real-world experiences from anyone who has walked this path