What I keep hearing from other high risk men is that they often refuse treatment because of quality of life. What does quality of life usually mean in these circumstances. We are talking about Libido and sexual function. Everyone has the absolute right to choose what treatment or treatment(s) they are willing to endure. But, I must agree with the last post, these same men refuse treatment and the cancer eventually spreads and in some cases very aggressively. It is at that point, these men want every treatment available to throw everything they can to stop the cancer. Since being diagnosed with de novo metastatic PC I have heard story after story of men refusing treatment. In my opinion, PC should never be treated by a Urologist. You are better served by a reputable Oncologist Urologist that can offer you every treatment possible to treat cancer aggressively.