Newly diagnosed: What influenced your treatment decision?

Diagnosed on Feb,2nd 2023. Radiation started in March 2023. Stage 4 PC, with pelvic lymph node involvement. Why wait?

Welcome to the club. I probably sound like a broken record, but my best piece of advice is go to a recognized "cancer center of excellence" if that's an option available to you. Google it and you'll easily find one. I did (Mayo Phoenix) and I was very happy I did. I felt the advice and care was outstanding. Also, I'd recommend Dr. Patrick Walsh's Guide to Surviving Prostate Cancer Paperback – October 3, 2023. It's on Amazon and it's the best $20 I ever spent. It really helped educate me on some key points in my decision making. It's organized in a way that makes it pretty easy to drill down on things applicable to your specific situation. Also, if you're looking for any suggestions on things I'd suggest sharing more info about your age, overall health, and the specific results on your tests. It'll help the folks on the forum better respond to your posts. One other thought I'd share is that for me (I was diagnosed on 3/30) the more you educate yourself the better you'll be able to discuss treatment with prospective providers and the better you'll be able to make the decisions you'll have to make. It's like drinking from a firehose at first, but it's worth the effort to get knowledgeable as quickly as possible. I guess one thing that surprised me was I'd never really been seriously sick before, so I didn't appreciate that I'd have to ultimately select my course of treatment. Yeah, you'll get recommendations, but the final decision on how you proceed will ultimately come back to you. So it's pretty important to understand your options at each step as thoroughly as possible, especially since selecting an option might eliminate other options going forward. Best wishes.

I was told they couldn't do anything until 2 months after the biopsy. It was an MRI-guided biopsy and I was asleep for the procedure.

Thanks for taking the time for such a comprehensive response. I'll get the book. I'm 66 with an irregular heartbeat (no damage to the heart function). Also never been seriously sick before. The test showed a Gleason of 4+3 (7). I've talked with two doctors in the past week. One described it as an entry level tumor, the other compared it to a dog and said it was not a labrador but not a pit bull.

I'll second @retireditguy on the importance of going to a "centre of excellence" (we just call them "Cancer Centres" in Canada, and they're usually attached to teaching hospitals and universities).

Not every individual urologist or radiation/medical oncologist keeps up with the latest research, and things have been moving forward at breathtaking speed over the past 5–10 years, so you'll have the best outcome at a big, multidisciplinary centre where the doctors are also researchers and teachers.

One thing I found useful was getting the actual reports of various tests from the providers portals and studying them myself. It took some effort to get through the terminology, but reading the test reports myself gave me the specific details necessary to more fully understand what they found. Also, as you dive into detailed information it allows you to better relate your specific case to the information you'll be reading about. I spoke with about 5 or 6 different providers along the way, and while everything they told me was "true", I found most of them tended to summarize my test results at a high level that wasn't terribly useful in helping me figure out what to do. Also, I think they tended to downplay the seriousness of the test results. I appreciate no one was trying to scare me into doing something rash, but studying my results helped me educate myself on this topic, ask better questions and put me in a better position to make decisions I needed to live with. Also, it's often wise to get a second opinion on your test results, especially if the results are open to interpretation. As you get further along I'll be happy to share the details of my case and why I made the decision I did. But more important than the decision will be understanding the "why". My neighbor 2 doors down was diagnosed with PC about the same time as me. One of us had surgery, and one of us had radiation. Frankly, I think we both made the right decision. When dealing with people and PC there's a lot of variables that inherently make every case a bit unique. Especially where they overlap, it'll be up to you to figure out which treatment makes the most sense for you. As always, best wishes.

I'm echoing @retireditguy. And specifically recommending Dr. Walsh's book. This isn't as easy as going to the dentist with a tooth ache. You must educate yourself on the different treatments for your specific circumstances. And, be wary of some practitioners tying too hard to sell their services. I'm not saying you'll run into that, but I did and it almost affected my ultimate decision.

I too was asleep, went thru the perineum got 13 biopsys. Started RT in March got done at end of month- 28 trips- had to have a full bladder during the procedure. Machine costs 4 million bucks. No side effects noted. They used SPACE OARS to protect the rectum and it did- no issues.

Something helpful to me was to take medical test results and doctor's notes, and paste them into ChatGPT with the instruction "Summarize the following text at an 8th grade level."

@anosmic1
MCC is going to provide you with vast access to the prostrate cancer club experience and knowledge.

As some have posted what is the level of experience and knowledge of the doctors and institutions you are seeing.

You will get many recommendations to get a second opinion both on biopsy and treatments plans. This will help you know the diagnosis and also the best treatsments for you.
A bone scan can help rule out spread to bones.
A PSMA can help determine if spread beyond prostrate and treatments.
A Decipher test can double check the biopsy (use say biopsy material that was done) test of what level of cancer you have and risk levels to help determine treatments needed.

There are so many new treatments and research now on prostrate cancer from even when I was researching and trying to decide on what type treatments were best for my cancer. Just remember this is your cancer, your body, and you need to make the decision on treatments and what is best for you as an individual.

Some urologist and R/Os will push surgery, hormone treatments, photon or proton. I am not sure about the term they used "entry level tumor." Never heard of that term when dealing with prostrate cancer. It should be what grade it is. This is were Decipher tests are so important as much more precise test of the cancer, grade and risks levels which should be used to determine treatments.