Many Men Chose The Wrong Prostate Cancer Treatment: Here’s Why

Comments · 497

• LA

  @lauralucialeale · 1 month ago

  My spouse was diagnosed at 67 years with prostate cancer October 2025 after an overnight at hospital when his BPH blew up and he had complete bladder blockage. He left the hospital wearing a Foley for nearly 3 months because he could not pee! DRE, MRI led to robotic radical proctectomy, last PSA was 3.5 prior surgery. Result: Grade 2, Gleason 3+4=7, small focus of prostatic adenocarcinoma invasion seminal vessel, Stage 3B. Post surgery PSAs: three months after 0.019; 9 months after, 0.026. He is relaxed, confident, happy to be alive and living fully. On the other hand, I ride a rollercoaster where my worries mount as we approach the follow up PSAs...his doctor reassures me that my spouse will be OK, but there is a 30% chance he will need treatment. Thank you for listening, it helps me to express this. And thank you for helping the community who is dealing with this disease! Appreciate any comments you may have. <3

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• RO

  @ronsax4820 · 1 month ago (edited)

  Thank you for giving a very clear and concise overview of all that needs to be considered after receiving a diagnosis. I am a 63yo male receiving a prostate cancer diagnosis some 2- months ago. The pre-history to this is that I heeded the warnings to men some 14yrs ago and took a PSA test which came back at 5.9ng/mmol which was considered high. I had  DRE and then an MRI which revealed a consistently opaque prostate gland on imaging, so I did not go ahead with biopsy though it was offered. Following attendance at charity fund raising event in April I needed the warnings again. My PSA was 95ng/mmol. I was then referred for tissue and bone scans which came back clear, then biosopy. Immediately prior to the biopsy the consultant oncologist compared the imaging and said subjectively that he could see no difference between then and now, that it was 31 grams in size and was similar to someone with an age of 21yo.  The biopsy findings was there were cancerous cells in the prostate and this was given a Gleason 7 score (4+3), medium to intermediate. I was then sent for a Liver scan, which caused no end of confusion as I thought they had confused me with someone else. The Liver scan also came back clear and then I was referred for an MRI/PetScan, where the lymph nodes have appeared to take up the radioactive tracer used.  I received a call last week where the receptionist said the consultant wanted to put me on Hormone tablets. No direct communication with the consultant or his team about, the results of the scans, what they did or did not suggest, reasons for additional referrals, the treatment modalities, the rational behind these and the options around the current risk characterisation.  This has been the way from the beginning, but I do appreciate just how many people the NHS-UK is trying to treat and support through the critical health phases of their life. I told the receptionist that I would not move in the direction until I am able to sit with the Consultant or his team and get some visibility on what the diagnostic screening has suggested. I would seriously welcome any thoughts you have on this. Many thanks in advance.

• CH

  @CharlesRogers-c3f · 1 month ago

  Firstly, Many thanks for these superb, clearly explained videos. Everything has been bought into much sharper focus. With regard to my own situation I am going to list ALL the information from the MRI scan and biopsy results that I have been given thus far and explain a little about my journey to this point. This all started when a close friend told me he had recently been diagnosed with a prostate cancer and was on active surveillance and I now know what he meant thanks to these videos. This prompted me to have a PSA test done as I was about to have my yearly thyroid function test done and did so in December 2024. The result was 3.5 and for my age of 62 years at the time, is considered to be in the normal range despite the fact that I was experiencing slight changes in my urinary function with slightly reduced stream when urinating and so no further tests were recommended or carried out.<br>When I went for my next thyroid function test in June this year, I again asked for a PSA test as the urinary symptoms had increased to the point where the stream was quite weak and I was going more frequently and clearly not fully emptying my bladder. This time the PSA result showed a raised level of 5.9. My Doctor immediately did the rectal examination and confirmed that my prostate felt enlarged and firm on one side and referred me to the hospital. The subsequent MRI scan revealed a Likert-4 large right sided lesion and according to the likert scale means that there is a high probability of clinically significant cancer. A biopsy then followed. The biopsy results indicated a T2b in the right lobe which decoded means that the tumour is still contained within the prostate gland on one &nbsp;side only and is greater than 50% of the lobe in size. The Gleason score turned out to be 4+4 with cancer present in 6 out of the 12 cores taken during the biopsy. The results also showed that Cribriform and intraductal carcinoma are present, all this pointing to a more aggressive type of cancer. HIFU as a possible treatment option has been ruled out.<br>Immediately started hormone treatment, Bicalutamide for seven days to cover tumour flare as the first hormone injection is given and for a further 7 days afterwards. As I write, I have just had a CT scan and will be having a bone scan tomorrow to check that the cancer has not spread. The options on the table for the main treatment are, as one would expect, a Radical prostatectomy or radiotherapy and that is where I am now. Just waiting for the results and doing as much research as I can over the next week or two so that when I go into the inevitable first meeting to discuss all the results, I go in informed and armed with all questions including those that Charles has mentioned in his videos.<br>From the incredibly clear and detailed explanations Charles has given, I am leaning towards surgery as, given the aggressive nature of my tumour, I really like the idea of having a much better plan B should the cancer return, specifically salvage radiotherapy to the prostate bed if needed. The other side effects I know I can deal with. To me it’s about doing the very best to ensure that I give myself the best possible chance should the cancer return. The continence should be sorted after a few weeks all going according to plan and gents if it means that Mr Wiggly won’t rise to the occasion as he used to, then so be it. To be able to spend more years with my wife, my sons and my friends means so much more to me than my sex life and I have my wonderful wife’s full support. I wish, that given I had symptoms when I first had the PSA test done, I had asked for the rectal examination to be carried out as well as the PSA test, apparently, does not show raised levels all the time despite the fact that cancer may well be present. So prostate mates, what I have learned from my journey thus far is take control of your situation, don’t rush into anything, do your research, speak to your partner and family and don’t be frightened to question your specialists. I wish you all the very best possible outcome on your journey.

• MA

  @Macbrowndog · 2 weeks ago

  I&apos;m &nbsp;am 71 and was diagnosed with prostate cancer 9 months ago (Gleason 3+4, broken down as 95% grade 3 and 5% grade 4). My PSA has been hovering between 7 and 9, and I’ve been on active surveillance since.<br>My latest PSA came back at 8.6, so my urologist decided to bring my next biopsy forward by 3 months. He wants to re-check the percentage of grade 4. He noted that if the grade 4 proportion hits 10% or higher, it’ll be time to move from active surveillance to active treatment (either surgery or radiation). If it stays as is (fingers crossed!), I’ll remain on active surveillance for now. Biopsy is set for 2 weeks from now.

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• LY

  @Lynn.Panadero4242 · 3 months ago

  I’m 67 diagnosed with unfavorable intermediate risk prostate cancer, Gleason scores 6 &amp; 7. PSA 5.4. &nbsp;<br><br>I’ve seen your videos about 3-4 months back. They have been very helpful with my decision making. &nbsp;However, today I’m running through your 4 steps in retrospect as I have had my first run of treatment. &nbsp;<br><br>I was not pleased with my urologist’s first direction for treatment. &nbsp;He based the decision entirely on test results and not on me at all (surgery). I asked for a second opinion about radiation. He shared that it was not an option because of my age. I was to report to the surgeon and schedule it asap. &nbsp;<br><br>I understood where he was coming from. Surgery was the best option for me given the diagnosis and age, until you consider that I am diabetic, have heart disease, liver disease, fibromyalgia, and chronic fatigue syndrome. &nbsp;Being medically fragile, I should have been considered to be a 77 year old, not 57 year old. &nbsp;<br><br>He finally consented to refer me to a radiology oncologist as long as I visited with the surgeon as well. (Per my insurance company, I could have self referred had he not agreed, but this helped keep the peace.) He was furious when I chose radiology and the possibility of just letting the cancer run its course. &nbsp;(Not active surveillance). I call it die with dignity. <br><br>The end result for my first round of treatment was 28 days of radiation with no hormone therapy. &nbsp;My testosterone is quite low to begin with. &nbsp;I do feel pretty good about my treatment; it is complete and I’ve have the initial 2 weeks of recovery. &nbsp;<br><br>However, &nbsp;there were conversations that you recommend in the video that no one was willing to have. &nbsp;Oncologists seem to be afraid to talk about cancer and posible terminal outcomes. &nbsp;“Everything is it’s going to work out great and we won’t worry about next steps until we are there.” &nbsp;I asked for a referral to discuss life with late stage cancer. &nbsp;I never got this opportunity. &nbsp;<br><br>In fact I am currently left hanging as my after care seems a bit thin. &nbsp;I’m scheduled for a PSA at 3 months, then every 6 months for 5 years. &nbsp;If all looks good I’m done. <br><br>When do I have another MRI or PET scan? &nbsp;At what point do I consider myself a cancer survivor instead of a cancer patient? How do I know that I am cancer free? Is there another cancer lurking about? &nbsp;My original PET scan only looked for prostate cancer cells.

• RO

  @robdelisle8293 · 1 month ago

  I just turned 70. I was diagnosed 6 years ago and chose to leave it alone. No treatment. I still enjoy the same quality of life that I enjoyed when I was diagnosed. I have a friend that was diagnosed two years ago and decided to undergo prostate removal<br> and now regrets that decision because of the side effects. Every man is different. I keep a check on my situation but as of now, I&apos;m good.

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• DA

  @David-k5o6g · 5 months ago

  Thank you so much for this really useful video. I am a retired counselling psychologist, literally on the wve of my first biopsy. I spent over 100 hundred hours since being informed I need the biopsy and ended up in a daze of technological confusion. I have clear concerns, preferences and priorities based on my life circumstances. Your presentation summaries all that I need do to map my perspective onto that of my specialist in 4 to 6 weeks when I get told my results. The clarity of understanding your expert advice provides is like a weight being lifted. There are enough issues and challenges for any human being as they deal with major junctions in their lives. Clear, evidence based advice in understandable language &nbsp;is a kind of gold standard &nbsp;of professional-patient communication. And tgat is what I see here. So once again thank you and keep up the great work. I will certainly recommend the site to anyone in search of a sound approach to decision-making. I intend to vist your site and follow up any further material you upload. I was a CNS in homelessness and Nurse Tutor before I trained as a psychologist. I would gladly use this video as an example of the level of communication medical professionals can aim for if I was still teaching. Of course I am still learning!

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• CH

  @chuckmiddleton2293 · 1 day ago (edited)

  Thank you. I had a slightly elevated PSA (3.5) and visited a Urologist. 2 of 10 cores were positive and a 6 Gleason Score and he wanted to &nbsp;schedule immediate surgery without discussing options. He tried to scare me and my wife and that felt intimidating. Went for a second opinion that started with a MRI and then a MRI guided biopsy. 12 cores 0 positive. New Doctor recommended Watchful Waiting/Active Surveillance. This was 7 yrs ago and my PSA has remained in the low to mid 3&apos;s which is normal for a 64 yr old.

• PH

  @PhilTunney-y8f · 5 months ago (edited)

  Thank you for your fantastic advice. I’m 59 and had a PSA of 6.5 after medication, Tamsulosin and Finasteride. My BHP finally caused total bladder retention after 2 years of active surveillance. I was eventually diagnosed with a Gleason score of 3+3=6 and had a nerve sparing robotically assisted laparoscopic prostatectomy in February 2026. First 2 weeks were uncomfortable but I’m now fully recovered and have full bladder control and erectile function.

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• LI

  @LindaMcKay-r5g · 1 month ago

  Great information thanks. <br>My husband if 68 has recently been duagnosed with prostate cancer . PSA levels 8.4 after asking for check at his annual check up. Rectal exam showed firm left side prostate. &nbsp;MRI was unequivocable so biopsies were instigated . 12 biopsies showed 6 +ve for slow growing &nbsp;contained adenocarcinoma.Gleason score 6.<br>He has &nbsp;type 2 diabetes,high bp &amp; mild angina, <br>Based on the fact that he is relatively healthy at this stage &nbsp;&amp; aware of all side effects he has opted for prostatectom<br>y.He is of the opinion that later on he may not be fit enough for surgery &amp; radiotherapy would make surgery more difficult in future.<br>Hope this helps.

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• KE

  @keyper555 · 4 months ago

  Thank you for your informative videos, I will be 67 on the 12th of May, I am overweight but in fairly good health, I recently had a full nephrectomy of my left kidney due to a lemon size tumor but Dr Greene doing robotic surgery got it all with all margins clear and I recovered very quickly with very little side effects. The History of my family included my Father succumbing to prostate cancer in 1991. It has been determined I have Prostate Cancer as well. My Prostate is double the original size and I have a PSA of 8.4, MRI showed 3 lesions, Biopsy showed two cores with a 4+3=7, and another two cores at 3+4=7 going for PET scan tomorrow to see if it has spread. I was originally going to opt for surgery but due to certain things it was recommended before PET scan to do the radiation Therapy with Hormone treatments. The same Dr who removed my Kidney will be doing the treatments. I have a family member who is a retired Urologist Dr Mike Conrad and he is my second opinion, we originally thought surgery might be the best way to go but after what Dr. Green said about having the previous surgery 7 months ago and the fact I am overweight he felt that radiation therapy would be a better course of treatment, We will know more after the PET scan results. What is your thoughts and do you agree with him? Thank you.

• BI

  @billking8843 · 5 months ago

  Another fantastic video. So much junk medical (mis)information on youtube but this is an oasis of quality information in an enormous desert.

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