Has Anyone Elected for No Treatment?

Yes, great comment. It definitely sucks to be part of this "brotherhood", but for the most part, PC is really one of the "best" cancers to have to come down with!
Always good to keep in mind how much worse things COULD be, no?

But that is a very sad story, and thanks for sharing it, Phil.

I think of two questions: what is the diagnosis (some just warrant active surveillance) and what are one’s longevity/quality of life goals. I have the hardest time convincing my (much younger) oncologists that at age 74 I anticipate < 10 years remaining and want more quality of life rather than pounding the cancer for a complete cure. Gleason 7, N1M0.

My husband at first was ready to say NO and die, it was his MANHOOD!
Lots of arguments over weeks, I have holes in my walls because I threw at chair at night screaming in the dark and being angry!
Now the attitudes have changed on both our ends.
He's fighting it with everything! My husband is 55 and stage 4 metastatic PC.... I'm 47, we still have kids at home! I'm too young to be a widow! He's too young to die, plus in the last year his parents passed away and I lost my mom two weeks after his diagnosis, so I can't deal with another loss!!
At some point we had 3 sets of ashes in our closet and I begged my husband to fight because I don't want a 4th!
Now we're hardly 6 months into it, near the end of Chemo and it's been a battle for sure...

I feel deeply for you and your husband especially since you are both so young. I hope he finds the strength to fight this horrible cancer if not for him but you and children. I’m a young 79 yr old who had prostate surgery a year ago , every day I wish that I had refused to do anything and not give up my quality of life and enjoy what time is left . I’ve had a loving relationship for 40 yrs with my younger wife but feel like a stranger now when we go to bed at night. Wishing you and family get the help you need to survive this .

So far my husband is ok. Tired and achy and worn out but it comes and goes.
I told him earlier that I'd rather have a husband and no sex life than a dead husband and still no sex life!

Easier for most women to give up a sex life than most men , before cancer once a week was enough for my wife since her appetite has diminished, but I was used to to 2-3 x a week. Not too many yrs ago now it’s over but my brain still feels like 50 , tough to accept

Three years ago one of my aPC buddies decided to quit treatments. He was two years in at the time. Those years were horrible. He lost his wife, and health insurance, while the bills piled up. He decided to call it good. He stopped treatments. Focused on exercise, nutrition, and updated his playlist daily. Now his life includes long walks, long bike rides, long library visits, and long coffee visits with friends every day. He is defiantly living his best version right now. He's 74. He's checked out Netherlands, and Canada for their assisted dying laws. He discovered it really comes down to controlling your own exit strategy. It takes a high quality of life country to with compassionate exit laws. He spent some time in each country. Met with docs, and care providers discovering the quality of life also includes quality of death. He plans to move to either country next year. I plan to visit him after he moves and maybe....

You wrote "He started having lower lumbar back pain in his early '70's. He just thought he was getting old. This was in the days before there was a PSA test. He was dead within a month."

The problem is that there are a lot of different things we call "prostate cancer" — there's the slow-developing kind that your father died *with* at age 99 rather than *of*, there's the fast spreading kind that I got, which can escape the prostate in months rather than years or decades (my oncologist said about 5% of prostate cancers are like that), there's even-rarer small cell neuroendocrine prostate cancer (NEPC), which moves quickly into vital organs (that may be what your friend's father had). When you hear anyone still making a blanket statement in 2025 like "Prostate cancer is slow developing" turn your B.S. meter up to 11.

Fortunately, we have better tools these days, so instead of just talking about "prostate cancer", oncologists can consider the Gleason score, the PSA doubling time, genomic tests (e.g. Decipher), epigenetic tests (e.g. EpiSwitch), germline tests (e.g. Invitae), and advanced imaging (e.g. MRI, PSMA-PET) to make a much more-accurate diagnosis about whether your cancer is likely to be slow-developing or dangerously-aggressive. It's not just a matter of flipping a coin (heads we treat, tails we don't) any more.

p.s. I also discovered my cancer initially via back pain and then loss of mobility, but luckily, a) it wasn't NEPC, and b) there were much better treatments available in 2021 than there were even 5–10 years earlier, so I'm still going strong.

It really was one of the symptoms that brought him to the doctor too, but we had a lot of stress in our lives with my in-laws old and dying, so a little magic pill did the trick usually. But before the desire was there but function lacked a bit, now it's nothing.....I miss it....a lot!

at 74, ....N1 means one pelvic lymph node is positive presumably found on a PSMA PETCT scan
it is my understanding that a radiation spot treatment will return you to the 'status quo ante'