Diagnosed with prostate cancer, where to go now in this moment?

@suzdog Search ‘radiation dermatitis’…very common.
Don’t know about itching all over, but definitely could occur on the abdomen, sides and back with prostate therapy. That’s ‘all over’ in my world!
The remedies are mostly the same as for severe dry skin or there are even some meds which may help…Best,
Phil

@heavyphil I am taking Cetirizine which in my head seems to be helping but the itching is not gone from everywhere. This is what I found out that is most closely tied to my symptoms. Radiation can cause a type of chronic, widespread itching known as neuropathic itch, which happens when nerve fibers are irritated or damaged rather than the skin itself.
When you received your prostate radiation treatments, the powerful energy beams had to pass through the pelvic floor and surrounding tissues. Even though radiation oncologists target the prostate as precisely as possible, healthy tissues—including the complex web of nerves in the pelvic region—absorb some of that energy.
Here is how that can translate into full-body or widespread itching:
• Disrupted Nerve Signaling: Radiation can injure or cause localized scarring (fibrosis) around microscopic nerve fibers. If the nerves that normally transmit sensory signals are damaged, they can start misfiring. Instead of sending a signal that says "pain" or "touch," they continuously fire a phantom signal that your brain interprets as a deep, unyielding itch.
• The Pelvic-Systemic Connection (Cross-Sensitization): The nerves in your pelvis share pathways and "switchboards" in your spinal cord with nerves that travel to other parts of your body. When nerves in the pelvic floor are chronically irritated, it can trigger a state called central sensitization. Essentially, the central nervous system becomes hyper-reactive, turning quiet nerve pathways throughout your entire body into an active, generalized itchy or crawling sensation.
• Neuropathic vs. Dermatological Itch: This explains why standard allergy medications (like antihistamines) or standard lotions don't work for you. A regular itch comes from histamines in the skin; a neuropathic itch comes from a misfiring nervous system.

@suzdog Thankfully, I never suffered from this SE; but I am pretty sure it is nerve related, not simply ‘dry skin’.
Have you tried acupuncture? Again, I have not had the need for it, but many friends and patients have found relief from many ailments not amenable to current medical practices. Best,
Phil

Very sorry to hear your diagnosis but by viewing this site, previous comments and advice that you will receive you will see that your initial diagnosis of a Gleason 7 (3+4) appears favorable. One thing that you will be encouraged to share is your detailed biopsy results as this will help guide many in their advice. Something that you did not mention is Decipher testing for determining the aggressiveness of the cancer. The comments will generally come in three groups, Radiation patients (multiple different types of Radiation protocols) that will take time to get a handle around that will certainly get explained to you. Surgery, less options but extremely important to understand the options and how they can affect possible side effects and quicker recovery time. What is important in the surgery realm, is the Surgeon’s expertise in how many he has done. If your Urologist says he can do the Surgery I would certainly be hesitant as he probably does not have the experience of the number of procedures that you need as he is more likely a jack of all trades(different surgeries) in the urology surgical world. The third area is possibly Active Surveillance. You will likely be asked to share some personal information like age and part of the country that you reside. Age is important in treatment consideration’s and where you live possible referrals to major cancer centers and experienced Radiation Oncologist’s and Surgeons in your area. You will be recommended to get second opinions regarding treatment approaches. I am a surgery case and highly recommend that you research Retzius sparing surgery or a similar procedure that does not cut the Puboprostatic ligament to the bladder. Most of the surgical techniques done by the majority of surgeons cut the ligament in a standard Robotic Assisted Laparoscopic Prostatectomy (RALP). It is important to know which actual procedure that you would possibly want to pursue if you go a surgical route to get referred to that surgeon. It is alot to digest and I could go on and on, but just getting your diagnosis you have time to gather information. Best if luck

@ap31126, you've gotten a lot of feedback from the guys. I hope this was helpful in your decision making. Maybe a little overwhelming?

How are you doing with the treatment decision making? How are doing in general?

@wheel1 , Thank you for all advice you have given me in my decision making it's tough deciding which way to go in my journey. I'm 60 yrs old and have a underlying condition called mitral valve prolapse with my heart so I shouldn't go the route of surgery due to how long the surgery is what I heard in my opinion. I'm passed the Active surveillance route what I was told.

Getting that first diagnosis is tough, as is all the decisions you'll be faced with. All I can do is tell you how I approached it when I was first diagnosed back in 2020, when I was 71. My gleason score was 9 (5+4).

This basic decision, as you've found, is to decide between surgery and ADT plus radiation. What I did was schedule a conference with the radiation oncologist, and the surgical oncologist. Both are very respected in their fields. I specifically asked them to give a complete, as neutral as they can, overview of their specialty and to tell me the pros and cons. Each sessions was about an hour and a half. They each, of course, were biased to their own approach, but both did admit that each approach was equally effective. My oncologist confirmed this.

I chose radiation and ABT for two reasons. One, there is less chance for urinary leakage. Two, with surgery there is a fair chance that you will eventually also have to have radiation and perhaps ADT.

For me, I think the decision was a good one. I've had zero urinary leakage and my cancer went into remission for five years. Unfortunately, it came out of remission last year and spread to my lungs, but I believe this would have eventually happened with a gleason score of 9, no matter which approach I chose.

So, my advice to you is to get a thorough review of the pros and cons of each approach as they apply to your specific situation and then make your decision.

Whatever you decide, best of luck and keep us informed.

Tom