So i want to give my update and thoughts for those considering SBRT. I spent months researching and reading journals after journals before choosing SBRT as a monotherapy with no ADT required for a favorable cancer. I chose it because i did not want to go through the surgery and recovery, i did not want to risk a short penis, incontinence, or erectile dysfunction. With SBRT the cure rates and biochemical control was s the best out of all treatments although statistically the difference was not much and they stacked up basically the same. I also did not want to risk the recurrence that comes with surgery then being forced into radiation as well. With radiation the bowel side effects with the spacer is 1%. Incontinence was virtually zero which was important to me. Im 65 so impotence was a big one as surgery had a much higher rate of erectile issues especially for men my age. A big issue i had that stressed me out was urination retention from high dose SBRT. I have a baseline IPSS score in the moderate range of 12 and thats with taking flomax. But i made the call because i wanted a better margin since my cancer abuts the capsule and surgery cannot provide that. I have a high volume gleason six in the transition zone and its a single lesion 27mm by 13mm. There is only a 10% chance of a missed higher grade as i had a thorough MRI targeted and systematic biopsy. But in case a higher grade is there i wanted a bigger margin around the capsule where it abuts. Also with a single lesion i was able to design a 40g dose on the lesion as a boost and a lower dose everywhere else. I went over a detailed plan with my radiation oncologist and physicist. So with the gold markers and spacer placed i started last Friday and completed 4 of 5 treatments. My final treatment is Monday. I had some urination slowing after the first treatment and after one day following treatment 2 i was urinating so slow and it was trickling out. I was already in a panic if i was going to get blockage since its usually after the third treatment the side effects start. After the third treatment i was urinating 4 times an hour and it was only about 1/2 to 1 ounce and i was like oh crap. All i wanted was to finish the treatments then if i needed a catheter so be it. So i was nervous but went in for treatment 4. Today is a day later and surprisingly the obstruction symptoms are still around the same. They are bad but i can still urinate enough where i am living a completely normal life. Unless im urinating i wouldn’t know i am getting treated. I have no painful urination, no fullness feeling in by bladder etc.. I go to the gym, shopping, whatever i normally do. Urinating is a bitch, but that is all right now. I also surprisingly only get up twice a night to urinate and sleep well. I know now i will be able to finish the fifth treatment on Monday, thank God. After my finall treatment i know i will need to make it a week when that is when symptoms should be peaked and are what they are. I have no idea yet if i will be running to urgent care for a catheter or not, but either way at least my treatment won’t be disrupted and its done as i really wanted this treatment over the rest. Ill keep you posted. Hope this helps men who are considering SBRT and who also has a larger prostate with ongoing BPH symptoms and a higher urinary score. One more thing. I am taking 2 flomax, 0.4mg each, one morning and one at night. Also have 600 mg Motrin for inflammation. Good luck everyone on your journey and i really wanted to post my experience in detail because with a higher IPSS score you can still get SBRT but may have to deal with more obstruction type symptoms like me. But so far i feel great and im almost at the finish line.

73M, PSA 10.8, PIRADS 5, Gleason 4+4=8 GG4, 4/12 samples positive, PET scan negative for spread. 

I’ve been lurking/commenting here since my diagnosis last spring. While the information and shared experiences are helpful and provide a dose of reality, they can also be overwhelming and even depressing at times. I wanted to share the positive experience I’ve had so far and offer some optimism to those with a similar pathology who are just starting this journey.

I’ve gone through all the standard steps: rising PSA, MRI, biopsy, PET scans, and agonizing decision-making. I chose surgery because it was a one-time procedure, avoiding 12-18 months of hormone therapy and other factors. While it wasn’t an easy journey, the experience and outcome have been positive for me.

The worst part was the biopsy and the two weeks with the catheter in place. The anxiety of facing surgery and the inevitable side effects were also significant. My surgery was 4.5 hours, but I was under anesthesia for that. One night in the hospital was tolerable, and I managed to deal with the catheter knowing that we all go through this and just have to tough it out. I had faith that my surgeon was skilled and caring.

The pathology following surgery showed no lymph node spread, and my cancer was downgraded to Gleason 4+3=7, GG 3. The cancer was determined to be contained within the prostate capsule. I’ve had two PSA tests, one at 6 weeks and my latest one at 12 weeks. Both results were <0.1 ng/ml and considered undetectable for PC. This is precisely the outcome I was hoping for, and I hope it will remain the same for the rest of my life. At 12 weeks post-surgery, I feel completely recovered, except for the ED, where it’s still too early to tell. I’m experiencing some positive sensations down there, but hey, I’m 73 years old, and sex isn’t the priority it might have been if I were a younger man.

In summary, while no one wants to face PC, it was a positive experience with the outcome exactly as one would hope. Support from my wife and daughter was crucial during the procedure and recovery. It wasn’t the end of the world for me, and I genuinely hope that all of you going through this can have the same experience and outcome as I have had so far.

BTW, physical therapy for pelvic floor a month prior to surgery was critical in getting control of incontinence in about 4-5 weeks following catheter removal and I recommend this for all who are facing surgery.

Good Day. I knew the day would come. Just a decade sooner than expected. I am 53. Relatives were all in 60s. Father had full surgery and has had urinary problems ever since. Caused much heartache for him. So that is second priority for me. Cure is first. I have been reading a lot about sbrt and adt. Have biopsy next week. Will keep you posted. I love data and advice please. Thank you.

It wouldn't fit in the title but please this question is only for those who were on the SHORT COURSE (4 TO 6 MONTHS) OF ORGOVYX. Two Questions:

1. How long after you stopped taking Orgovyx did you begin to feel better?

2. How long after you stopped taking Orgovyx did you feel totally better, like your old self again?

I am taking several ADT-related meds including an anti-depressant, FlowMax, Cialis, and Oxybutynin, and I would like to have a basic framework for when I might start tapering down and eventually stopping these meds. I am currently in my last month of Orgovyx. Thank you.

In 2nd year of active surveilance, last MRI indicated a 'bulge'. Was thinking of some kind of focal therapy since everthing just mentions left apex. I'm wondering if a detailed 3d image of the prostate showing exactly where the "region of interest" is would be useful to make treatment decisions? I've heard of something called 3D Slicer. Thanks.

How long did you wait for a diagnosis? From DRE to Biopsy to diagnosis. For me it was 4 months. Now waiting for CT and PET scans in next few weeks, yet to be confirmed.

Could you provide some information about the prostate biopsy procedure at a university hospital? Will I be completely naked during the procedure? I assume I’ll need to spread my legs. I heard the procedure is performed right below the testicles. Also, since it’s a university hospital, there might be students present during the procedure. I feel embarrassed. Should I shave my genital area before going? I suppose a lot of people will see my lower body.

Hello everyone! My father is 68 years old. Because of PI-RADS 5 finding, he underwent a transperineal MRI fusion biopsy and the following has been found:

Findings consistent with acinar adenocarcinoma of the prostate, Gleason score 3+4 (<5%) = 7/10, Grade Group 2, identified in 10/25 biopsy sites, with a maximum tumor involvement length of 5 mm.

The tumor cells are arranged in glandular structures of variable size and shape, with irregular and relatively crowded distribution, and focally, over a very limited extent, in biopsy site “3”, with formation of cribriform structures. Carcinoma is identified in biopsy sites “1, 3, 4, 6, 7, 8, 9, 13, 19 and 25”, measuring 2 mm, 1.5 mm, 3 mm, 4 mm, 2 mm, 2 mm, 2.5 mm, 2 mm, 2 mm and 5 mm in length, respectively. No perineural or vascular invasion is identified, nor is there evidence of extraprostatic extension.  The biopsy material from sites “2, 5, 10, 11 and 23” consists exclusively of fibromuscular and adipose tissue and striated muscle fibers, with no prostatic glands identified.

Pre-biopsy timeline

January 2026 mpMRI: 8 mm lesion, PI-RADS 3 in the right peripheral zone.

August 2026 mpMRI: 20 mm lesion PI-RADS 5, extending in an arc-like fashion along the right peripheral zone; EPE absent. A second opinion on both MRIs was the same, with the radiologist saying that the lesion bulged the capsule without breaching it.

Prostate volume: 27 cc.

PSA (Jan–Aug): fluctuating between 3.45–3.9; free/total ratio 15–17%.

DRE: Smooth, well-defined prostate with mild right-sided heterogeneity.

I have been actively reading posts on this sub since last month and I am finding it extremely supportive, with many people here taking holistic approach. I went with my father to the  urologist a few times. Now as the biopsy results have come in, some questions are  closed, but many more are open. The urologist opted for surgery and my father is very up for that, for psychological reasons.

How does this all look to you? What do you think about cancer being on 10/25 samples? Do biopsy, PSA and MRI make a coherent picture here? What I am particularly interested in is how concerning the cribriform pattern (present in one sample, ’very limited extent’) here is. Also, is PSMA PET recommended?  

I know that many of these questions are for doctors, and we are gonna talk to them, pursuing several opinions. But I am very happy to hear your insights, opinions, similar situations, anything that you would add or ask the doctor.

For the context, we live in Serbia, there is no such thing as a specialized prostate cancer center, but there are some prominent urologists coming here, and some of the neighboring countries can be an option for treatment. Also, do you think that conventional laparoscopic radical prostatectomy is ok because RALP is not being performed in our country?

Thank you all!

My psa consistently came over 3.0 since the first time 6 months ago it was high and doctor said it could be elevated due to sexual activity you are too young for cancer screening. Then after 6 months it came high again then ordered the third time just to be sure. Booked appointment for prostate MRI.

Do they insert probe inside for MRI or all is done externally?
If it’s not cancer what could it be?

Hi all,

I'm looking for existing Claude Skills, system instructions, or MCP tools specifically tailored to prostate cancer (e.g., parsing pathology/biopsy reports, reviewing NCCN/EAU guidelines, interpreting Gleason/ISUP scores, or tracking recent clinical studies).

Has anyone built or shared an open-source workflow/skill file for this, or integrated Claude via MCP with biomedical databases (like PubMed/NCBI) for oncology research?

Any pointers, GitHub repos, or shared .md skill templates would be greatly appreciated.

On my own I have a project in cloud Science with my case files

Regards

Info: Age 59, Gleason 3+4, Grade 2, Decipher of 0.74 (high risk) and PET scan showed the cancer has not metastasized. I'm currently recovering from an unsuccessful RP. Unfortunately the surgeon could not separate my prostate from my rectum. After an hour of trying he felt it wasn't worth the risk of tearing the rectum lining. I now have a consultation to speak to the Radiologist who originally recommended IMRT treatment. Two questions. Has anyone else ever had this issue and if the prostate and rectum can't be separated (no spacer) how bad are the side effects of radiation on the bowels?

Hope someone can share some insight.

Had successful prostatectomy June 2024. Completed 25 radiation treatments in April 2026. Started Orgovyx right before treatments and have been on it since. Until the last month I needed only 1 pad for incontinence mostly "just in case". I could do yard work, housework, go to store etc. without a pad. I mostly wore it to golf, bowl and when I work part-time at a golf course and am on my feet all day.

A month ago, I started leaking horrendously and going through 2 pads just while working. My Medical Oncologist referred me to my urologist who thinks it's an overactive bladder and wants me to "trial a medication called Myrbetriq or mirabegron that can help with overactive bladder or urinary leakage." I'm a bit concerned about the side effects - " This medication would require you to monitor your blood pressure at home as one of the side effects is the potential to increase blood pressure. Other side effects can be GI upset, headaches, however it is usually generally well tolerated. If you experience urinary retention (unable to urinate) on the medication you would want to stop the medication. If you are unable to urinate at all and developed bladder pressure/pain, it is recommended to proceed to the ER for further evaluation"

I know when I always sat on the toilet I would drip was told this was normal because there is nothing there to stop the pee. When this sudden onset of incontinence started, I thought perhaps because now that my penis has shrunk so much because of Orgovyx that is just hangs there in my underwear and leaks just like it does when it hangs on the toilet.

Has anyone else experienced a sudden onset of incontinence after such long time after treatment or was diagnosed with an overactive bladder this long after radiation?

Thanks

I am thankful for this community and all the information that I learn, my father (57) was diagnosed in May this year (3+4 gleason, bone metastasis) even though he has had cancer for at least two years but never went to the doctor. They started him on hormone blockers and chemo, but I dont think its high doses since he was very weak and lost lot of weight. He has had 5 rounds of chemo, has one left. And they plan to give him what they call "smart medicine" in my country, I think it has something to do with blocking PARP inhibitors (his dad also had prostate cancer).

After his second chemo and hormone blockers he was better and put on some weight, he had no pain, he started walking more and doing more around the house, eating and sleeping well. He only had issues with small amounts of liquid around lungs and low hemoglobin. He did not have any problems with chemo..

But his PSA is slowly rising in every blood test he does before chemo. He started with 390 > went down to 68, and 10 by 10 he is now at 137 again. I am really scared because I am aware that is not good. His doctor ofcourse will have him do scans to know more, but until then I cant help but to feel stressed.. Anyone experienced something like this and it turned out to be okay?

In my case maybe not everyone’s, but after your RALP surgery you’ll have a Supra pubic catheter in for about 7 to 9 days before it will need to be removed. I just had mine removed and wanted to share my experience so everyone is in the know where most of this was not included in my paperwork.
The day before it was removed I was able to urinate normally and other than the occasional cough / sprinkle, I did feel closer and closer to normalcy. Last night I slept with the bag connected to avoid any mishaps. This morning I disconnected the bag and everything returned the same as yesterday. I arrived to my appointment and when they finally called me back, and prior to sitting on the table I did ask if I should try to urinate prior to its removal. The nurse said no I didn’t need to. Let me tell you guys, just go, insist on going just prior to the removal and bring a spare pair of clothes just in case. I did wear a diaper and brought a spare. I just had to pull my shirt up a little and my shorts down a bit while on the table. She deflates the internal bubble and asked me to take a deep breath and let me say, nothing prepares you for that sudden split second feeling of it being pulled out. It’s not painful but it is an awkward oh shit moment. Nothing I’ve ever felt in my lifetime. Immediately, urine starts to erupt from the site and down my sides, soaking the top of my shorts and the base of my T-shirt. She grabs some absorbent pads in an attempt to stop or guide the leakage but the effort was not quite enough to prevent it from wetting my clothes. So now I’m in the car, wife driving of course, I’m sitting on multiple absorbent pads and I smell like pee. So bring a spare pair of clothes, extra diaper, towel or two and go urinate just before they remove the catheter.

Completed my MRI today (interesting 2 week process after machine broke on first attempt and before first retake attempt). Results seem good after running them through Chatgpt. What are my logical next steps?

I'm leaning towards a PSE exam, a 2nd Opinion on the Radiology report, and a PSA exam.

I feel like I can breath again for the first time in 2 months. This forum's members and the information they've provided have been amazing!

General Information: Age 49. Jan 30, 2024 PSA 2.11, Jun 30, 2026 PSA 4.4., PSA Density 0.1419

Previous Cancer: Thyroid Age 29, 2 X Ablation doses of Radioactive Iodine

MRI Results:

IMPRESSION:

1. No suspicious PI-RADS 3 or higher lesions.

2. Sequela of prior prostatitis or fibrosis, PI-RADS 2.

3. Normal prostatic volume of 31 cc.

STUDY: MRI Pelvis without and with contrast, prostate protocol

INDICATION: ELEVATED PSA COMPARISON: None.

TECHNIQUE: MR images were obtained of the pelvis with and without contrast utilizing the prostate protocol.

FINDINGS: PROSTATE: 4.4 cm TR x 3.2 cm AP x 4.4 cm CC for a volume of 31 cc.

No suspicious PI-RADS 3 or higher lesions. Linear and wedgelike areas of vague T2 hypointensity in the peripheral zone are typical of prostatitis or fibrosis, PI-RADS 2..

NEUROVASCULAR BUNDLES: No evidence for neurovascular invasion.

SEMINAL VESICALS: Unremarkable.

LYMPH NODES: No pathologic pelvic lymph nodes.

One year ago today I had my prostate removed. The fear and uncertainty I felt almost led me to turn amd run at the door of the hospital. I called my uncle and he calmed me down. I am 100% happy with my decision. I hope that each and everyone of you can have such great results. Please do not allow the fear and uncertainty to overwhelm you. The kegels and after care therapy really help. Good luck to all of you on this journey.

I just a place to vent. Today is, hopefully, my last dose of radiation. It is 11:15 pm and I am supposed to go to work in 10 minutes. I called off because I have only had a couple of hours of sleep. I wake up because I have to pee, which burns (no fevers or chills) and /or I have pressure in my rectum that makes feel like I have to go, but usually turns out to be gas. The painful peeing and the pressure I can kind of tolerate, the insomnia is something I did not expect. To be honest, I had no idea what to expect. The stuff I was worried about didn’t materialize and what didn’t seem like an issue at the beginning has now become the issue.

It’s very frustrating. I am that typical I will figure it out guy. I can’t figure this it out and it is distressing.

Thank you for letting me vent.

Update: Thank you to everyone who has responded. I am on Flomax, doc doubled it to the max dosage. My wife suggested AZO, I wasn’t sure what it did. I will pick some up if it will help with the burning.

Hi Guys,

I wanted to come back with what may be my final major update for a while, and most importantly, to thank this incredible community.

My husband (60) was diagnosed in March 2026 with high-volume metastatic hormone-sensitive prostate cancer (mHSPC). At diagnosis, his PSA was approximately 1,956 ng/mL.

His initial investigations showed:

Gleason 8 (3+5), Grade Group 4
PI-RADS 5 lesion, with seminal vesicle involvement and suspected extracapsular extension
Extensive pelvic and retroperitoneal lymphadenopathy
Widespread bone metastases involving the spine, ribs, pelvis and other skeletal sites

His diagnosis came while we were travelling in the Philippines, resulting in a medical evacuation back to Australia. We knew very little about prostate cancer at the time. This community quickly became one of my most valuable sources of information, shared experience and support. I lurked, read and asked questions.

Treatment
He commenced triplet therapy in April/May 2026:
Androgen deprivation therapy (ADT)
Degarelix (Firmagon), commencing 11 April 2026, initially a 240 mg loading dose followed by 80 mg monthly injections. Following completion of chemotherapy, his ongoing ADT is transitioning to leuprorelin (Lucrin), administered every 12 weeks.

Androgen receptor pathway inhibitor (ARPI)
Darolutamide (Nubeqa), commenced 11 April 2026.
600 mg twice daily (two 300 mg tablets per dose), totalling 1,200 mg daily. This treatment is continuing.

Chemotherapy
Docetaxel, six cycles administered approximately every three weeks.
First cycle: 26 May 2026.
Sixth and final planned cycle: 10 September 2026.

Pegfilgrastim (Ziextenzo) administered following chemotherapy for neutrophil support. There is currently no further chemotherapy planned.

PSA response
His PSA has fallen dramatically throughout treatment:

1,956 → 91 → 3.3 → 0.4 → 0.32 → 0.23 → 0.20 → 0.10 → 0.040 → 0.030 ng/mL

His latest PSA, from October 2026, is 0.030 ng/mL.

His testosterone has also been suppressed to castrate levels with ADT.

October 2026 — Post-chemotherapy PSMA PET
On 8 October, we met with his oncologist to review the latest PSMA PET scan and blood results. The Dr was extremely happy and described my husband’s response to treatment as near-complete.

The findings were enormously encouraging:

Only minimal residual PSMA activity within the prostate.
No significant residual PSMA activity in the previously involved lymph nodes.
No significant residual PSMA activity in the previously involved skeletal lesions.
Marked reduction in the size of previously enlarged lymph nodes.
No new PSMA-avid sites of disease identified.

Considering the extensive metastatic burden at diagnosis, the difference between his initial imaging and his post-chemotherapy scan is remarkable.

We understand that a near-complete imaging response does not mean metastatic prostate cancer has been cured. He will continue systemic treatment and regular monitoring. Nevertheless, this is an exceptionally encouraging response to his initial treatment.

Side effects and tolerability
Overall, he has tolerated triplet therapy remarkably well.

We’ve dealt with:
Fatigue and occasional brain fog.
Bone and muscle aches, particularly following chemotherapy and pegfilgrastim.
Hot flushes associated with ADT.
Taste changes.
Mild anaemia and some changes in blood counts.
A persistent facial rash and redness, particularly associated with dexamethasone.
One episode of an irregular heart rhythm during Cycle 4, which was assessed in hospital and subsequently settled.
Thankfully, he has experienced no significant peripheral neuropathy.

We used a cold cap, cooling mittens and cooling booties (Suzzi Caps from
Amazon - we used two sets as they defrosted quickly and I’m certain his hair loss was because at the start we only had one set) and he sucked on frozen pineapple (tinned rings cut into thirds (and he used POLYBALM for his nails ) throughout the chemotherapy.

He retained most of his hair and avoided troublesome nail and nerve symptoms.

His appetite remained excellent, and he maintained a surprisingly good level of physical activity, including exercise and gardening between cycles.

Now that chemotherapy is behind him, we’re beginning to see signs of recovery.

What happens next?
He is now moving into the next phase of treatment. He will continue:

Lucrin injections every 12 weeks for androgen deprivation.
Darolutamide (Nubeqa) 600 mg twice daily.
Regular PSA, testosterone and other blood monitoring.
Ongoing oncology follow-up.

And now for something that means an enormous amount to us personally. Our Doctor has given us medical clearance to return to Indonesia in November!

Before his diagnosis, we’d spent considerable time travelling around Southeast Asia, particularly in Indonesia, which has become a very special place for us. Our plans were understandably put on hold when he became ill.

We’ve now arranged our travel around his ongoing treatment schedule.

We’ll return to Adelaide every 12 weeks (84 days), specifically for his scheduled Lucrin injections and associated medical monitoring, before heading back to Indonesia.

It’s an arrangement that allows him to continue receiving his treatment in Australia while giving us the opportunity to return to the lifestyle we love.

After six months of chemotherapy appointments, injections, blood tests, scans and uncertainty, having something wonderful to look forward to feels like an enormous milestone in itself.

A very heartfelt thank you

When I first found this community, I was frightened, overwhelmed and desperately trying to understand what was happening to my husband.

I had never imagined I’d need to learn about PSA density, Gleason scores, PSMA PET imaging, androgen deprivation, androgen receptor inhibitors, docetaxel or metastatic disease.

But here we are.

You helped me understand the terminology, interpret information, prepare questions for his oncologist, navigate side effects and make sense of the decisions we were facing.

More importantly, you helped me feel that we weren’t navigating it alone.

I know that not everyone experiences the same response to treatment, and I would never suggest that our experience predicts anyone else’s outcome.

But I remember how much it meant to me in those early weeks/months to read about people who had responded well to treatment.

I hope sharing our experience might offer that same encouragement to someone else who has just received a frightening diagnosis.

March 2026:
PSA 1,956 ng/mL. Extensive lymph node and bone metastases. A diagnosis that completely turned our lives upside down.

October 2026:
PSA 0.030 ng/mL. Near-complete response on PSMA PET. Six cycles of docetaxel completed. Ongoing hormonal therapy established. And, wonderfully, medical clearance to return to Indonesia. We couldn’t have hoped for more encouraging news at this stage. Although travel insurance is posing its own challenges!

To everyone who has answered my questions, shared your knowledge, told me about your own experiences, offered reassurance or simply taken the time to respond:

Thank you, from the bottom of my heart.

You’ve made a real difference to our lives during an incredibly challenging six months. We’ll continue to take things as they come, enjoy the good news we’ve received and concentrate on living our lives.

Wishing every one of you the very best with your own treatment journeys.

With love and gratitude from Australia.

Just a bit of recap on my dad’s results here . RO is suggesting a 3 months ADT with SBRT..how can we be sure that he needs ADT or not? Every other doctor seems to have their own views. I really want to avoid ADT for him if it has no extra benefits in his case since he is on hypertension meds already.

PSA
PSA: 4.9 ng/mL
Age: 64
PSA has been increasing over time.

MRI
Prostate approximately 40 × 48 × 48 mm.
MRI showed bilateral transition-zone lesions classified as PI-RADS 3, thought to be related to BPH.
No pelvic lymphadenopathy reported.
No obvious extracapsular extension or seminal-vesicle involvement reported.
Biopsy was subsequently performed.

Biopsy – 14 cores
Cancer was found in 5/14 cores:
Right peripheral base: Gleason 3+3, 20%
Right peripheral mid: Gleason 3+3, 10%, with small focus of perineural invasion
Right peripheral apex: Gleason 3+3, 10%, with small focus of perineural invasion
Right parasagittal apex: Gleason 3+4, 60%, pattern 4 = 10%
Right transition-zone fusion biopsy: Gleason 3+4, 60%, pattern 4 = 30%
Overall:
Gleason 3+4 = 7, Grade Group 2
The remaining left-sided cores were negative for invasive cancer, although there was PIN in two cores.

PSMA PET/CT – September 2026
The scan showed PSMA uptake in:
Right and left peripheral zones at the base
Right peripheral zone at the mid-prostate
But importantly:
“No definite scan evidence of PSMA-expressing loco-regional/distant metastases.”

Seminal vesicles were unremarkable and there were no definite PSMA-avid metastatic lymph nodes.
One thing we are trying to understand is why the PSMA scan showed some uptake at the left base, while the left-sided biopsy cores were negative.

Concern About My Urinary Symptoms
I am concerned about my ongoing urinary symptoms, which include:
Frequent urination, sometimes every 4 times in an hour during the day.
Waking up 2–3 times at night to urinate.
Strong urinary urgency, sometimes making it difficult to hold my urine.
A weaker urine stream than I used to have.
Occasionally needing to push or strain to urinate.
Intermittent lower abdominal and pelvic discomfort.
Sometimes passing only small amounts of urine.
These symptoms have been present for a long time, and some have become more noticeable.
My last PSA was in 2021 and it was 0.20 ng/mL My recent PSA on October 8, 2026, was 0.24 ng/mL, and my urologist described my digital rectal examination (DRE) as unremarkable.
Although these results are reassuring regarding prostate cancer, I remain concerned about what is causing my urinary symptoms. The only way to know is through a biopsy and my PSA went up
I would like to understand whether these symptoms could be related to an enlarged prostate, my understanding this most common on men’s over 60, can this still be cancer ? Should I ask for more specific test ? Sorry guys I’m just so confused the urination is terrible I can’t be on a place for 20 minutes without the urgency to pee, something must be off

My main concern is finding out why I urinate so frequently and why my urinary stream has become weaker, I know prostate cancer can cause this symptoms!

Latest PSA is <0.01, undetectable!

3mo: 0.04

6 mo: <0.02

9 mo: <0.01

Makes me feel good about my treatment decision.

Thanks to all for the great info in this group!

The patient is 73 years old and currently has absolutely no symptoms or physical problems. The journey started purely because a routine blood test showed a PSA of 9.1. Following a consultation with a urologist, we got further testing done.

I have attached the PSMA PET-CT scan and TRUS-guided prostate biopsy report to this post for exact medical context.

For those who were in a similar situation and chose radiation:

• How effective was it for you, especially if you started out asymptomatic?
• What were the short-term and long-term side effects like?
• If you had to choose between surgery and radiation at this age/PSA level/diagnosis, what made you lean toward radiotherapy?

Any insights, personal stories, or advice on what to ask the oncologist at our next appointment would mean the world to us. Thank you so much.

Thought it would be a good idea to share here to see if there are any men who have experienced more than one post SBRT bounce.

Quick background - 60 year old diagnosed with PC in Mar 25, two tumours found via biopsy - 5 samples had gleason 4+4; 2 had 4+3; 3 had 3+3. High risk category - T2. Pre treatment PSA was 2.76. Decided on SBRT (Cyberknife) and had barrigel and fidicual markers beforehand. Have not been prescribed ADT. I am blessed (for now at least) with full function down there and there is still (surprisingly) ejaculate being produced.

The graph shows the journey with my PSA levels - it has stayed lower than the pre-treatment result with the latest being 1.57. Given the fluctuations the radiation oncologist ordered two PSMA/PET scans - one in April 26 and another just a week ago. The latest scan was via a Siemens Quadra PET scanner - apparently the 'ducks nuts' so to speak in terms of resolution.

I expected and was prepared for the classic 'bounce' which I thought was what was occurring in April this year after the PSA increased from 1.36 to 1.7 but it then dropped back down to 1.4 at the time of the PSMA/PET scan (which luckily didn't show any metastases or lymph node involvement). However, when the PSA went up again in June and then again in Sept 26 hence the second scan.

The result from the latest scan has allayed my concerns - there is no indication of any metastases or lymph node involvement and the prostate itself doesn't show any evidence of disease either - Phew!

My next PSA test is early 27 - I'll be keeping my fingers and other body parts crossed for no recurrence.

Have any men experienced multiple bounces following SBRT?

Thanks again to this community for all the support and sharing of valuable information!

i have posted and commented here, this is a great group of men, very helpfull, thank yall for the info, i had ralp in jan and it spread they also took 6 lymphnodes, first psa after RALP i was 5.1, so tues i finished 39 of 39 rounds of radiation and rang the bell, i am on aberitone and luprone until april 2028

Joined the club 6 weeks ago,

Quite the journey...

Pathology = clear margins.

Had 1st PSA yesterday.

Came back < 0.05

I think this is normal and perhaps a bit too soon assume anything?

Thanks for your feedback