No reason to hit the panic button. I remember my diagnosis, the shock, the angst...as I say, that's ok, then, the pity party is over, time to face and deal with the diagnosis.

Starting point may be to build a multi-disciplinary team, urologist, radiologist and oncologist. They should have as a focus, treating prostate cancer. As time marches on, you my want to add others, cardiologist, diet and nutrition, a physical fitness trainer

Next up, inform yourself, While you want to listen to your medical team, it is you who is the best advocate based on the outcomes you want. These forums have members who medical team are behind the times, some through their own styles, others just too darn busy to stay abreast. Read the NCCN Guidelines and gather every scrap of clinical data - imaging, labs, biopsies. I would look into triplet therapy and discuss with your multi-disciplinary team.

Yes there is hope, odds are it's not just going to fall into your lap, you're going to have to go get it. The rate of change in imaging and treatments since I was diagnosed in 2014 have been exponential with more following.

I've posted "my rules" before on this forum but they may be food for thought as you begin your journey.

1. Please know your stuff. As a member of my medical team, you should have a thorough knowledge of my cancer and of the latest developments in research, and be ready to formulate a plan of attack. 

2. Please do your homework. I expect you to have reviewed my medical records prior to my appointment. You have looked at my x-rays; you have my pathology report; you know how many children I have. In the world of cancer care, every scrap of data must be scrutinized for its significance.

3. Respect my point of view. Leaders listen to all sides thoughtfully before reaching a conclusion. With patience and finesse, I am sure you can help me to feel confident about the plan you have shaped for me. 

4. Be curious. Do not close your mind to new hypotheses and don’t ignore clues that might lead you toward the best results. Please rid yourself of the temptation to make your day easier by delivering perfunctory care. 

5. When it’s decision time, decide! If you think treating my cancer is not worth it; if you think I am at the point where I should stop chemotherapy; if I have veered off the path you have cleared for me—then speak up! Care for me with a dogged determination to get me healthy and do not keep any secrets that might lead to regret. I want an oncologist who knows what is best for me and doesn’t chicken out in difficult times. 

6. Be responsible. Follow up on promises and follow through on tasks. I can tell you with absolute certainty that there is no greater disappointment than realizing that you cannot rely on your doctor. 

7. Talk to me. I need your advice, comfort, and expertise; I am scared and discouraged—are you willing to take a seat, look me in the face, and answer my questions? Leaders welcome scrutiny of their communication skills. No one cares if a flunky is curt.

My Rules:

Don’t Walk In Cold to an appointment.  To make sure I do the best thing for my individual prostate cancer, I need to educate myself. *Knowledge will empower my BS detector. When Dr. Thrasher and Dr. Emmott told me monotherapy ADT is what I need and did not want to talk about imagining and combining other therapies such as radiation and chemotherapy, I didn’t just have to accept their advice on faith (I just fired my urologist when his ego got in the way of his ability to help in my treatment decision). 

Walk in the door ready to start the conversation at a different level.  I don’t have to spend time talking about the basics, things like Gleason grade and clinical stage and what they mean.  I already know.  I can have an intelligent discussion about the merits of a particularly treatment for my cancer, my likelihood of being cured, and risk of side effects.

I won’t blindly accept the opinion of a non-specialist– I know that my cancer requires a team approach.

Once I make an informed decision and carry it out, I never look back. Well, that is not entirely true, I look for lessons learned from that decision. The path is always forward: I continue to learn about PCa and always look ahead. What counts is today and what lies in the future. Yesterday is gone, so forget it, well, learn from it.

I educate myself as completely as possible and take the time I need, I always know that no matter the outcome of a particular choice, I make the best possible decision. That knowledge that I have thought my decisions through carefully is what is really important—and may be more important than the decision itself.

Finally, lower you horizon. Your medical may talk about life expectancy and if that's long, 15-20 years, may not be the lens you look through in making treatment decisions.. Perhaps the next five years, will this work for the next five years, if so, more treatment options will be on the decision pallette.

Kevin