Hey Folks. I’ve been a lurker for nearly 2 years now and thought it time to introduce myself. This post is lengthy. I want to share with the community for my own benefit and future visitors to this sub. I would also welcome any feedback on the pre/post op plans.

While a longer expression of my gratitude is at the end of this post, I truly appreciate and respect each and every one of you for the patience, support and courage you demonstrate with the strangers in this sub. Thanks for reviewing my pre and post op plans and provide any feedback you think might help.

Summary

50M, SoCal USA resident. RARP scheduled for 10/26/2026 at UCLA with Dr Robert Reiter. I am fairly active and somewhat fit. Have been lifting weights for about 4 years now. Currently lifting 3 days a week with intense pickleball 2-3 times a week. I have been cutting excess weight slowly for years and estimate that I am under 20% body fat today. I have a dexa next week to get a pre-op baseline. Was 29% (dexa) last July.

PCa History

Random PSA performed in September 2024. No family history, no pain, no prostate indications - nothing. Shout out to my Kaiser PCP for checking the box and saving my life.

Quick Timeline of Major PCa Events to Date

• Sep 2024 Initial PSA 4.5 (blood test, just prior to turning 48)
• Dec 2024 Pelvic MRI
• Jan 2025 Biopsy confirmed PCa
• Jun 2025 Consult with Reiter
• Jan 2026 Prostate MRI @ UCLA (PSA 5.1)
• Mar 2026 Biopsy @ UCLA with Dr Wayne Brisbane
• May 2026 Sample sent for Decipher
• Jun 2026 Reiter recommended RARP within 3-6 months
• Sep 2026 PreOp with UCLA Men’s Sexual Health clinic
• Oct 2026 RARP scheduled

Summary of Findings

• Gleason 6 (3+3)
• Grade Group 1
• Decipher score 0.52 (intermediate)
• 13 of 17 cores positive (high volume, bilateral, low grade)
• 2 lesions, neither penetrating the capsule but one abutting

Summary of Decision

I am fortunate to live in Southern California where we have a high density of Centers of Excellence. Shortly after diagnosis, we switched to a PPO to have more flexibility with treatment options. USC, UCLA, Scripps and City of Hope Duarte were all excellent options available to me. I opted for Dr Reiter and UCLA given the sheer number of RARP procedures he has performed and his contribution to the advancement of men’s urologic health. And it hasn’t just been Reiter. My biopsy was performed by Dr Brisbane who is conducting amazing research studies to create non-invasive prostate scans which yield the same results as traditional biopsies. The coordination with the men’s sexual health team is awesome too. They recognize that sexual health is not just ego or pleasure, but an essential way of life for men. They are helping to reduce the stigma of all the various treatment options post op as well. One other notable point is that Dr Reiter practices placental allograft nerve wraps in an effort to stimulate nerve recovery. Results are inconclusive but it doesn’t hurt.

Pre-Op Plan

• 7 days out: stop all supplements, lifting and pickleball. Will shift diet from cutting to maintenance. Goal is to rebuild glycogen stores to aid in healing post op.
• 24 hours prior: usual bowel void
• Staying in hotel nearby in case I have a 5:30am arrival time

Post Op Plan

• Recovering at home with my wife’s support, though she filed for divorce earlier this year. We’re amicable and she insisted on being there for recovery. Honestly unsure how that dynamic will play out during a vulnerable stretch, if anyone’s navigated recovery with an ex or separating spouse as caregiver, I’d welcome your take.
• Catheter removal and voiding test 7 days later.
• Post op review at 60 day out
• Sexual Health visit at 60 days out as well
• The list:
  • Catheter support
    • 5 gallon bucket OR Carabiner with grocery bag to hook onto my pants
    • Neosporin with Lidocaine for tip lubrication
    • Tear away sweat pants
    • Boxers
    • Tena pads
    • Waterproof bedsheet
  • Pain Mgmt
    • Whatever the doc gives
    • Tylenol
    • THC/CBD drops. I’d prefer this route over narcotics. Thankfully we are a 420 friendly state.
    • Heating pad for abdominal pain
  • Other
    • GasX (for the CO2)
    • Miralax
    • Inflatable cushion
    • Squeezy App (for Kegels)
    • Lidocaine rollon (for incision care, have not yet bought)
    • Merderma advanced gel scar (for incision care, have not yet bought)
  • Sexual function
    • 5mg Cialis daily
    • L Citrulline daily
    • Pelvic floor therapy clinical study with Zimmer PF Toner Chair (at UCLA)
    • Back up options: RestoreX (Penile Traction Therapy Device, $600), implants, Trimix injections, penis pump

Gratitude

If you made it this far, thanks for reading everything. Thanks to everyone on this sub for talking openly about your experiences. You are an example for all of us who follow. Your bravery to open up while dealing with the health anxiety is true masculinity. I am grateful for the support of my guy friends who have all been amazing through a pretty rough year. And I am especially grateful for my adult sons who have given me something else to focus on while I manage two major life events.

To those who might read this in the future, I’ve learned that none of us need to endure this alone. You’re here now and you will be ok. We’re in this together.

My grandfather had stage 4 prostate cancer. Lived 3 years after diagnosis. He started pluvicto and the first 2 treatments went well, 3rd one he had bad side effects and so dropped the treatment. After dropping it, the cancer exploded everywhere and he was dead 3 months later. Is this common? I truly feel like the pluvicto killed him and I don’t know if my feelings are valid.

I'm 39 years old about to turn 40 next month and just did my first PSA test. My results came back with a 2.5 total PSA and a 8% free PSA. Ive been using 1mg finasteride for hair loss and from what I've read that means I should double my total PSA from 2.5 to 5. It was a routine check up blood test, I was told to fast but I was not told to not have ejaculated prior to taking the exam for 48 hours although realistically im not sure how much it could've skewed the test. FWIW my father was diagnosed prostate cancer in his 60s. I dont have any of the negative symptoms, or pain or trouble urinating at all. This news has hit me like a ton of bricks today reading that 8% is a high likelihood of PC. I just had a son and I finally bought a house. My career is at a place I can be proud of. Now I cant stop over thinking about my own mortality. I recognize that there are people in this forum who may be in a situation much worse than I that would love to change places healthwise, so im not making light of that but would like some guidance since my dad isnt around anymore.

Thank you.

Hey all

I just got the results back from my first ever PSA test. (Very fast! I only had it tested a few days ago)

Anyway as per the title it came back at 2.68 which is red.

I am a anxious. I already have a GP appointment for the day after tomorrow so I will mention my PSA result then. Do I need to get an emergency GP tomorrow or will the day after do?

Is there anything else I should be doing? How worried should I be?

Edit: More info, I am white, 5ft7" and I am not aware of a history of prostate cancer in my family.

So I had an MRI that showed 2 6mm lesions in the right side peripheral zone. Got my biopsy completed and both of those showed up as benign or possibly that the biopsy missed the lesions. It did find a small amount elsewhere in the prostate that came back as gleason 6 GG1. Grok is saying that the biopsy is non-diagnostic for the lesions. So the doctor just missed and this was of no value?

• Lesion 1: PI-RADS 4 - 0.6 cm in right apex.
• Lesion 2: PI-RADS 4 - 0.6 cm in right apex.

Final Diagnosis

Part 1: Prostate, R1, MRI-fusion biopsy: - Benign fibromuscular tissue. - No prostatic glands present for microscopic assessment.

Part 2: Prostate, R2, MRI-fusion biopsy: - Benign prostatic tissue. - No prostatic glands present for microscopic assessment.

Part 3: Prostate, RB, needle biopsy: - Benign prostatic tissue.

Part 4: Prostate, RP, needle biopsy: - Single microscopic focus (<0.05 cm) with few small atypical glands.

Part 5: Prostate, RA, needle biopsy: - Benign prostatic tissue.

Part 6: Prostate, LP, needle biopsy: - Benign prostatic tissue.

Part 7: Prostate, LB, needle biopsy: - Prostatic adenocarcinoma, acinar type, Gleason score 3+3=6 (grade group I), involving one of one (1/1) core (5-10%). - No perineural invasion.

Part 8: Prostate, LA, needle biopsy: - Prostatic adenocarcinoma, acinar type, Gleason score 3+3=6 (grade group I), involving one of one (1/1) core (45%). - No perineural invasion.

Gross Description

1.Prostate: R1

Part 1 is received in formalin labeled with the patient's name, "R1". Fragment(s): 3 tan-white cores

Range of length per core: 1.2-1.4 cm

Average diameter: 0.1 cm

2.Prostate: R2 Part 2 is received in formalin labeled with the patient's name, "R2". Fragment(s): 2 tan-white cores

Range of length per core: 0.7-1.6 cm

Average diameter: 0.1 cm

I'm 3 months in on Orgovyx. 2 days ago I was in the local gym trying to offset the ADT side effects with exercise. A woman in front of me dropped her phone and bent over to pick it up, she was commando and I got a full rear view of everything she had down there. Not so long ago I would have been staring with desire and trying to keep down an erection, this time nothing at all registered. What shocked me was that it wasn't until afterwards I even realised what I had been looking at. I think I understand now what it means to be sexless.

Pues ya me han dado el resultado de mi RM. Pi-rads 5. Pasado mañana la biopsia. En fin. Estoy entre nervioso y deprimido. Hay una zona de 14mm x 7 x 10 sospechosa en el apex derecho. Y también zona irregular en la grasa que separa la próstata del recto. Lo único positivo que los ganglios parecen estar bien. No afirma que haya salido fuera pero si que ha afectado esa zona de grasa. Vesículas seminales bien. Tamaño 35cc. Lo dicho lo peor pone "sugiere infiltración extragandular" en la zona que os dije. Pues eso, depre.... A ver la biopsia pero no parece tener buena pinta, verdad?

M45, 6’1”, 190#, Caucasian, nonsmoker, seldom drinker, no medications aside from vitamins.

My dad had prostate cancer at a relatively early age, so for the past few years I’ve had PSA tests done just to stay ahead of anything. I’ve got my annual test coming up. Just wondering, besides the common advice of avoiding ejaculation or exercise like bike riding in the couple days prior to the blood draw, is there anything else to do or not do? Just looking to avoid any sort of false high or low indications.

Im about 120 days from having my prostate lasered psa gone from 8 to 1.3 and is expected to be lower after the 6 month test . So things are good . Here is my problem , I dont get hard anymore . Sometimes on the toilet or on the couch I start to get hard(i think) and then 20 seconds later its gone . The squirting machine still works but not that . Now I know I've had a procedure most havent had but I qualified for the study so it made more sense to me than ralp at the time . Anyone had the symptoms im describing? I just keep kinda waiting but I think after 120 days it might be time to ask some questions. Anyone got answers? TIA

I’m one month in on a 24 month course of Orgovyx and Nubeqa.

I’m wondering if anyone out there has consistently had basically undetectable readings a couple of times in a row and was allowed to stop before the end of their term?

UPDATE: I should have posted my history. PSA 10+. Biopsy showed 9 of 12 sectors positive: 2 4+3 and the rest 3+4 or under. RALP on 2/25/26. 2 positive margins. PSA 0.4 10 weeks post surgery. PSMA PET scan showed 5 lymph nodes with tracer detection.

UPDATE 2: I am currently finishing 25 fractions of photon radiation.

I (62M overall good health) was recently diagnosed w/ a 3+4, and am leaning towards SBRT.

Is there a way to find out the relative success for SBRT between facilities? My local hospital is a good regional hospital, but I'm 3-4 hours away from University of Michigan, Chicago, etc...

Some people asked if I did it to update them. This is just my experience definitely not telling anyone else to do the same. I am 46yr old male. Got prostate removed at Mayo Aug 20th. The surgeon did it by hand did noy use robotic. He said surgery went great couldnt be happier with the job he did.

But anyway after the surgery I started taking BPC 157 and TB500 Also creatine. Had my catheter in for 14 days. Here is my results.

The incontinence.... None wore a pad for first week. Really very little leaking. If i had to push to pass gas. I still leak a very little but thats it. I have not needed the pads. After first week I ditched them.

ED.... Day catheter came out i started 5mg of cialis a day. After 2 weeks I took a send 2 or 3 days a weeks. After 3rd. 15mg 2 or 3 times a week. I was told use it or loose it. So I made it a point to "Do my homework" masturbate almost every day. Most of the time very little happened. The days the wife helped there was at least a lil life. But good news this weekend I was able to get almost fully there. About 90% wife said. It was enough for penitration. That was Saturday. Sunday tried it on my own only about 40% but on Saturday I said what the hell and took 20 MG od cialis.

Just my 7 week journey so for. When I asked others about peptides noone had said they tried it. After months of research I thought for me it was worth the risk to try it for a month. I promised I would give an update on it.

I am happy to answer any questions.

For now, anyway. Too many high risk factors made two years of ADT plus Nubeqa a wise choice. I tolerated it pretty well but I am so looking forward to getting my strength, stamina, libido and pre-treatment body back. Eventually.

Hola a todos y mucha fuerza. Os cuento. Hace año y medio tuve una crisis de salud, y me salió diabetes 2, hipertensión, hígado mal....etc etc. Y un psa de 3,8 y 7,7 de porcentaje. Después de cuidarme, pastillas, etc y adelgazar 20 kilos me salió todo bien y a los 6 meses 3,4 y 14,8 de porcentaje. La primera vez mi médico de cabecera me pidió cita con el urólogo que tardó 7 meses. Pero después de ese resultado pues parecía que no haría falta, pero 6 meses después 4,5 y 10,4. Bien pues fui al urólogo, me hizo tacto rectal y me encontró próstata tipo III e indurancia bilateral en el apex. El mismo me dijo que había que hacer biopsia y pediría también RM. Pero que como está tardarían en avisarme 6 meses pues mejor hacer biopsia. Pero el caso es que por sorpresa alguien dejó libre una cita y me llamaron. Hice la RM con contraste el día 1. El día antes me llamaron para fijar fecha de biopsia. Les dije que al día siguiente tenía RM. entonces dijeron que ya me llamarían. Pues sin saber nada aún de la RM me dan cita para biopsia para este miércoles. Les digo por TF que aun no tenía resultados de RM. La señora ni idea y me dice que va a mirar y que me llamará. A las 2 horas me llama y me dice que se mantiene la cita. Que supone que les llegará. No es más lógico ver y analizar la RM con el urólogo y que a partir de ahí se decida? A parte me dice que no me pueden anestesiar ya que se lo pedí porque soy muy nervioso. No se, que hacer. No ir o cambiar la fecha de la biopsia y esperar que me informen de la RM? Y si esta diera nivel 1 y no necesitará biopsia. Me angustia la biopsia transrectal. No se cómo no me lo dan pidiéndolo. Igual no les daba tiempo ya que se requiere quirófano. En fin, cómo veis mi situación y que debo hacer? Encima ayer tuve que ir a urgencias y tengo una infección de bronquios y ya empecé con antibiótico que tengo que tomar durante 5 días al menos. Perdonar mi pregunta cuando veo gente que está mucho peor, pero estoy solo y perdido. Vivo en España y el hospital es universitario. Gracias a todos.

Yeah, lucky for me. I don’t take any or go Wees. I’m going all natural.

Posting on behalf of my father (66M). He has what seems to be an aggressive and persistent case of PC (background below).

Background:
Gleason 4+4
RALP (August 2024)
Pathology report indicated cribiform pattern present, EPE, limited margins, and LVI. It also confirmed no lymph node spread, no SVI, and no urinary bladder neck invasion.
His follow up PSA never went to undetectable so we decided on Early Salvage Radiation (completed April 2025). PSA went down slightly since treatment but has been trending up of late. Full PSA levels below:

2/2024- 4.0
Prostatectomy (8/2024)
11/2024- 0.1
2/2025- 0.122
Salvage radiation (completed 4/2025)
8/2025- 0.105
2/2026- 0.209
4/2026 - 0.200
10/2026 - 0.380

After RALP and early salvage radiation, just trying to see what the immediate next steps are here. His PSADT seems to be about 6 months which isn’t great, but it lowered for a bit earlier this year so maybe it’s still bouncing around?

I imagine we should be looking at a 3 month PSA test (and continue this for foreseeable future) as well as another PSMA PET scan. There seems to be some debate on how high PSA should be for the PSMA scan to be worth it (I’ve seen anywhere from 0.2 to 0.5 to 1.0), any input on this? If it picks up on anything, they’d likely zap that area from my understanding. Regardless, it seems he’s destined for some sort of hormone therapy at some point early next year (also seeing some debate on when he should be starting this)? It was always a bit of a shock to me that his oncologist didn’t recommend hormone therapy to be paired with his salvage radiation when he was going through it given his numbers, but they are a cancer center of excellence so we’re trusting them. We will be seeing his oncologist again next week, but just wanted to pulse this group here for advice beforehand.

Thanks all

EDIT: Forgot to add that my dad also had a PSMA scan done prior to his RALP procedure which found no evidence of spread outside the prostate at that time

Stage 4 Prostate Cancer with cancer through out lymph nodes in body. Started Orgovyx on 17 September and was prescribed 50 Mg Sildenafil @ 6 pills per prescription. Is this to counter the side effects of treatment and reduce permanent damage to functions after treatment?

Do I take in # of days Intervals?

My first psa after HIFU didn't really drop from pre HIFU. Doctor ordered a retest and PSA has risen .5 in 1 month. Waiting to hear back from doctor but a bit stressed...

Hi everyone,

In response to a previous thread about leaking after salvage radiation I’m sharing a list of foods and drinks that can irritate the bladder. This was given to me by my physical therapist. I hope it’s helpful.

I’m a low volume patient and I’m pretty dammed happy with these results. I’m currently on ADT and Abiraterone, which my oncologist originally said I’d be on forever. Following a total of 25 radiation sessions on my prostate and bone met, my PSA tested .018. At some point in the future, I’m going to ask my oncologist: “Given my MMAI score of 0.31 and my low-volume metastatic disease, does this result give you any reason to reconsider the intensity or duration of my systemic therapy?”

Hi all. Third time posting. Haven't been on here in over a month. My dad finally got his biopsy results in late August. He has a Gleason 7 (3+4). I have just been busy and haven't been on here much. He also got his PSMA PET scan results recently. Good news! No spread! Right now we have been getting second and third opinions from a few good surgeons in our area. We are trying to find the right surgeon. We are going with surgery since radiation is off the table because of how the prostate is pushing into the bladder because of how huge it is. It will simultaneously get rid of his urinary issues and the cancer so it looks like this is the route we are going. I'm am trying to convince my dad to also get a Decipher score. The biopsy results are shown below. Also, do any of you have any good recommendations for surgeons in the Philadelphia area?

Day 4 of my second chemo cycle. Gleason 8
I’m feeling achy and just generally unwell, but no fever. Did anyone else feel like this around day 4? Does it get better over the next few days? ❤️

Has anyone tried alternatives to Trimix, like Quad or any of the other drugs that have been popping up online?

49 years old...almost 50

22 PSA, PI-RADS 3 lesion, Gleason 4+3

I had the surgery the 29th at 7:30am and was home by 1:30 p.m. Unfortunately, the catheter was not draining properly when we got home, so we had to go back to the ER the first night and get that taken care of. I had not drained at all for abourt 6 hours by that point, and I could really feel the pressure. They irrigated it and pulled out a clot and it was instant relief. Everything was back in a "flow state" from there.

I felt the most pain from the CO2 inflation on the first 3 days, in the shoulders especially. And the abdomen pain that feels a bit like someone hit you in the stomach with a baseball bat one time. But it does get a bit better every day. Still fairly sore in the perinuem area also.

I did do lots of walking, 5-6 times a day. Now that the catheter is out I was able to work a little around the house this week

I've been fortunate with the urinary incontinence issue, as I have not leaked one time since they removed the catheter four days ago. I did plenty of exercises before and had two sessions with a pelvic floor specialist before the surgery. I used the Squeezy app was hitting that thing like I was an Olympic athlete, and have been using it again now that the catheter is out. Having the catheter in does iritate the ureathra and has been causing some buring during urination.

I did get the report from pathology showing clean margins and no spread anywhere in the lymph nodes, that was great to hear. I was assigned Gleason Grade 3 pre-surgeryI and both surgerons thought I would get downgraded. The outcome was acatully more agressive then the Biopsy showed. They kept me at Gleason Grade 3, even found a small amount of Grade 5, and showed the cribform pattern. It had progressed showing significant cancer on 41% of the entire prostate, but no signs of it outside of the prostate. Looking forward to the hopefully near zero PSA test in five weeks, and every three months after that for a while.

One thing that I do not think is discussed enough here is the mental healing you may also go through in addtion to the physical healing. It is a mental backflip to know that the surgery will save your life, but you are also knowingly entering into a procedure that will forever take some things from you, as well as keep you without some functionalities for an unknown time. I was able to spend the first 4 days with just me and my wife without any distractions from work or other family, and that was very welcome as I found the need to really focus inward to process it all and I am still working on it. Those first few days felt very "delicate". I find there is a certain type bravery needed to make the decision to face surgery or radiation, I am proud of and I respect every man that is forced into having to make this choice.

Epididymitis post brachytherapy. Had it treated with antibiotics and anti inflammatory medication. But the pain has returned a month after it had cleared. What are peoples experiences 🤔