So I'm 7 weeks post RALP. Everything was going swimmingly. Incontinence is gone, Sexual performance is possible. Been really happy to be slightly moving on. That is until I got my PSA test resutls this evening. It's a 0.3 . I haven't spoken to my doctor yet, but this feels super discouraging. Ugh. Backstory..........48yo, Gleason 3+4, clear margins, clear fat, invasion of both seminal vesicles, Focal EPE.

A quick summary;

49 years old, in very good shape, strong, amazing support group, and strong-wiiled. I have a lot of faith as well and am mentally taking this in stride.

A few months back, with no blatant symptoms, recieved a PSA of 81. The next was 90.

Skip to MRI, two large masses, one smaller, no signs of spreading.

Biopsy shows 7&8's on the Gleason, some 4+4s, 3+4's.

PET scan tomorrow, crossing fingers about the spreading, robot surgery on Seot 24th.

I have an excellent Urologist, I trust him and his team, and they're through a Kaiser facility in Oregon.

A side note, I'm great with pain, have had many gnarly injuries, and have invasive procedures in the past, but I've got to say, the biopsy was brutal! Is it common for them not to give you anything but a local anesthetic? Nothing else during or after and I wouldn't wish the procedure upon anyone. They took 24 core samples and it was rough.

Thanks everyone, love you all, and I hope to add some light to others in the future.

My 47 year old man was just recently diagnosed with prostrate cancer. Only symptom was a weaker urine stream. His initial psa was 115 and then repeated a week later was 123. He had the biopsy and was 4+4=8 gleason 8 with cribiform present. He is awaiting pet scans to be scheduled. I haven't seen many people his age who have been diagnosed wirh a psa this high. We are scared and know the scans will give us more info and answers but was wondering what others psa results were.​

I have been researching life in the post RALP world with respect to dormant PCa cells. There is a fair amount of information out there but there is a fair amount of speculation that those of us who have had a successful RALP and then go through a time period where we get undetectable PSA levels may have dormant PCa cells in our body. The most logical suspects include the prostate bed and or surrounding lymph nodes or other tissue. Unlike active PCa cells the dormant ones are much different with a completely different metabolic state. Cell multiplication is very very slow. However one day they do actually activate and are no longer dormant. This explains many cases of BCR for men who have had successful RALPs, then a few years down the line.... we experience BCR and have to have some sort of treatment. The science behind detection and possible treatment of dormant cells is out there, and there have even been some studies on treating active cells in a manner that makes them dormant, as opposed to killing them with radiation or chemo, but there is nothing successful yet.

There does seem to be some that feel that early adjuvant therapy such as radiation does enough damage to the dna of dormant cells that when they do activate, they will not be able to multiply but I haven't searched hard enough to find anything firm.

However it does have me thinking that well, I am a year into my post RALP life without anything detected yet... but I am pretty darn sure I am living on borrowed time and am thinking about asking my doc about considering adjuvant therapy. The location would be the question since nothing is detected and dormant cells are not detectable or so I think but I would just tell him nail the prostate bed...and perhaps this could be done without ADT.

Just thinking out loud to see what others have felt about dormant PCa cells.

Monday was a good day. Cath out, no incontinence.

Today not so much. Path results -

- ​​​​EPE, non focal, left posterior and anterior.

- ​Margins involved invasive carcinoma - right anterior and posterior, ​left posterior.

- lymph nodes clear.

- 4+3 in 70%

- ​​Cribiform

- tertiary pattern 5 - 4.7%

Radiation consult tomorrow. Any advice appreciated. ​​

Hello everyone~~

It may sound crazy but I’d like to share my experience.

My PSA at Feb 2026 was 4.5. The biopsy at May 12th 2026 says 3 out of 12 cores were 3+3 and 4 out of 12 were 3+4 (only 10% are pattern 4). My doctor wants for me to have HIFU to remove whole prostate.

There are many research papers on NAM for cancer, arthritis, dementia, glaucoma, gum disease etc. When cancer is developed due to deactivation of gene RUNX3 (which is anti-cancer gene and discovered by Korean scientist), NAM can activate RUNX3 ( the scientist conducted numerous mouse experiments and one clinical trial against Stage 4 lung cancer patients for 5 years). So cancer can be treated (not all cancers can be treated BTW). It is known that only 23% of Prostate Cancer is caused by deactivation of RUNX3 while 72% of lung cancer is developed due to the deactivation of RUNX3.

I have been taking 2,000 mg of NAM daily since May 28^th 20026. After three months of taking NAM, the PSA dropped to 4.3. See chart above. The PSA was 5.0 at July 30^th and then dropped to 4.3 at Aug. 26th.  In a month, the PSA was dropped by 0.7!!! The drop is 14% over a month. Is it measurement error or temporary drop?

Due to physical stimulus, ejaculation, inflammation etc, PSA can rise temporarily and go back to normal state. However, is it possible for PSA to drop suddenly and then rapidly rise? I hope that NAM kills some cancer cells in my prostate. I am hoping PSA becomes around 3.6 by the end of this September. Yes of course this does not mean cancer is cured. But what can cause such a fast decrease of PSA? The normal cells of prostate disappeared in a month? Or some cancer cells are killed? I don’t know.

I will take another PSA test at the end of this September and report to you.

My prostate size is 30cc. For a week before PSA test, I stop any excercise (biking, kegel excercise etc) and sex to avoid random rise of PSA.

The scientist studied cancer for 30 years in University as a professor (now he retired). He runs a YouTube channel and Blog (sorry all in Korean). He published numorous papers. But pharmaceutical companies have zero interest as Vitamin B3 is not patentable. In fact they don't like the professor is going out and gives shoutout. He didn't claim NAM will cure all cancers but some cancers can be cured. In his YouTube channel and Blog, there are many posts or replies saying that their tumor size is reduced or undetectable. For example, very old breast cancer patient didn't want to have a surgery or radiaition. She has no choice but to try NAM. In a few months, among her 18mm, 12mm, 8mm tumors, two tumors are reduced.

If the PSA does not drop in next test, I will take the HIFU. But if it drops again, i will ask my doc for AS. Lets see

Fingers crossed!!

###### some calculations ######

N= # of normal cells, M=# of cancer cells

a=M/N is the ratio of # of cancer cells to # of normal cells, a>0

x= PSA release per normal cell, y= PSA release per cancer cell

b=y/x, b>1 ex. b=1

Assume a,b, x,y, N are unchanged while M is changed to M’.

due to 14% drop, we have

0.86*(xN+yM)=xN+yM’ where M’ is new M value.

0.86*(N+abN)=N+bM’

0.86abN-0.14N=bM’

M’=0.86aN-0.14N/b=(0.86a-0.14/b)N where ab>0.14/0.86=0.163

Let’s assume b=10 and a=0.2 for example

Then, M’=0.158N --> From 0.2/(1+0.2)=16.67% to 0.158/(1+0.158)= 13.6%. so 16.67%-13.6%=3.07% reduction in # of cancer cells compared to total # of cells even if PSA reduction is 14%

But for reduction of cancer cells compared to a month, we have 21% reduction because 1-0.158/0.2=0.21

In curious if anyone has an inspirational story about maintaining some level of sexual function with injections, pump etc as well as maintaining muscle mass by lifting while on ADT. My husband is about to start two years of ADT after a prostatectomy. He’s 49, very fit, and we had an active and great sex life before all this. Injections did work during post-surgery recovery, kudos to him for doing them, I know a lot of guys just will not cross the line with needles but it is so worth it. He’s doing everything he can to get better. Thank you 🙏

I am wondering if anyone did/is doing male rehab, before, during or after radiation treatment. I saw someone mentioned penis health program some where in this sub. I am wondering if it is a thing. My question is not just about penis health, instead of more about management overall health, side effects related Cancer treatment with Radiation therapy.

Thanks all and wish every one with a good health life!!!

Hi Brothers,

I just posted here on my 15 month check up, but thought I would ask more specifically (almost in form of a poll) since the science seems a little murky on that matter.

If you had a PSA bounce after radiation treatment …

1) How many months after treatment did this happen?
2) How big was the PSA bounce (from bottom to peak)?
3) How long did it take to resolve?
4) What was your treatment and did you have ADT?
5) Any other comments or thoughts?

I think these data points, although anecdotal, will help anyone going through this.

Many thanks for your input!

Hi Brothers,

I am getting a little worried …

Just had my 15 month checkup after SBRT w/o ADT for a G3+4 with 10% pattern 4 but somewhat higher total volume (5 out of 9 samples positive, all on one side) at age 53. Decipher was 0.5.

I get my PSA checked every three months:

Start of treatment 4.2
3 months 2.7
6 months 1.7
9 months 1.1
12 months 1.9
13.5 months 1.55
15 months 2.14

The 13.5 month was done for good measure after the bounce at 12 months.

I have been posting here regularly and last time the consensus was that it is probably a radiation bounce. I am not so sure anymore.

How do long would a bounce take to resolve?

Claude AI says “textbook bounce pattern”, but I am not liking this at all and am getting worried.

Messaged my RO and am waiting for a response.

Thanks and stay strong!

Hi all. I had my RALP about 4 months ago. My recovery has been progressing. I haven't had amazing recoveries like some patients, but I feel like I've made progress and am being patient. The big piece of good news is that my PSA was undetectably low after 3 months.

About a month ago, I noticed bloody urine in my pads during two 2-4 mile runs. I notified my surgeon's office and discussed it with him a few weeks ago when we had the 3-month follow up appointment. He tested my urine for infection and while I don't think I explicitly heard the results, I assume them to be negative. His theory for the bloody urine is that the stitches in the internal plumbing are still in there and maybe be rubbing against tissue. He did not say to avoid physical exertion. He asked me to send him pictures if it happens again. I thought that might be TMI, but he's a professional!

Yesterday I started peeing blood for the first time since that second run with bloody urine (my last run, as it turns out). I had been moving around a bunch during the day, but my activity level was not abnormal and did not require exertion like running. By 6:30 AM this morning, my urine returned to normal. Now it's looking like there may be traces of blood in there again.

I sent my surgeon pictures like he asked and gave him an update in the morning. I am wondering what other possible causes may be, how to make it go away, and how long this might last. My wife pointed out that blood in urine is a symptom of UTI, but I was tested recently. If you had a similar experience, please let me know.

My husband is having horrible issues sleeping since beginning ADT. He is so exhausted it’s seriously affecting his well-being. Has anyone found anything that works well to counteract this?

Do ADT side effects get better or worse over time?

Currently in the middle of 23 EBRT and a month post brachytherapy wich I developed an infection after and am currently on antibiotics so getting hit from all angles.

My friend, 77 yrs old, will need to do radiation. What kind of fatigue or other issues should he expect? I had RALP and so, have no insight for him.

Just a question and views on Retatrutide.
Has anyone on here heard about how this new, revolutionary peptide, may help in the fight against cancer?
Have seen a lot recently on it.
From what I’ve read, it certainly seems like it may control how it grows.

https://www.instagram.com/reel/Dc1wPi_xZg3/?igsi=MWpkOWxhZ3l4MXFvdg==

Hello, I have a question about Pluvicto that I’m hoping someone here might have experienced something similar. My husband had his first infusion about 4 weeks ago and he has developed severe sciatica pain. I have read that this can be from pluvicto. I am so hopeful that this works for him but I’m worried about this pain he has been dealing with.

Hi everyone,
I’m writing about my 66-year-old father, who was recently diagnosed with prostate cancer. Our family is trying to understand what we are dealing with and, most importantly, what kind of experiences other men with a similar diagnosis have had.
Here are all the details we have so far:
Age: 66
PSA: 77.82 ng/mL (June 2026)
Biopsy: prostate adenocarcinoma
All 6 biopsy cores were positive for cancer
Cancer was found on both sides of the prostate
Several cores showed Gleason 8 (4+4)
WHO Grade Group 4
Other cores showed Gleason 7b (4+3)
Tumor involvement was very high:
60% in one core
100% in another
95% in another
90% in another
100% in another
75% in another
Perineural invasion (Pn1) was present
The pathology report describes cribriform growth
The pathology diagnosis is a poorly differentiated acinar adenocarcinoma of the prostate
Pathology report: pT1c, G3, Pn1
The CT scan also showed a prostate abnormality and suspicious lymph nodes.
Most importantly, there were two suspicious bone lesions:
L2 (second lumbar vertebra)
Left ischium
The radiology report described these bone lesions as being compatible with possible bone metastases.
So at the moment, we don’t know for certain how many metastases he has. The CT has identified these two suspicious bone lesions, but we have not yet had a PSMA-PET/CT to properly stage the disease.
His general condition was described as good, and he is currently being referred to NCT Heidelberg for further evaluation and treatment planning.
What we are trying to understand
If anyone has had a similar diagnosis, I would really appreciate hearing your experience.
Especially if you had:
Gleason 8 (4+4)
PSA around 70–80
Grade Group 4
High tumor involvement in the biopsy
Cribriform pattern
Perineural invasion
A small number of suspected bone metastases
Lymph-node involvement
A similar age
What happened after your PSMA-PET/CT?
Did it confirm the bone metastases, or did some of the suspicious lesions turn out not to be cancer?
What treatment did you receive?
Did you start with hormone therapy (ADT)? Did you also receive an additional androgen-receptor medication such as darolutamide, enzalutamide, apalutamide or abiraterone?
Did anyone receive chemotherapy such as docetaxel?
If you had only a few bone metastases, did you receive radiation to the prostate and/or the individual bone lesions?
And most importantly:
How are you doing now?
How long has your treatment been working? How low did your PSA get? Are you still responding to hormone therapy?
If you were diagnosed with something similar, please tell me your age, PSA, Gleason score, number/location of metastases, treatment and how long you have been stable.
We’re trying to find people with a genuinely comparable situation so we can understand what is realistically possible.
Thank you very much to anyone who takes the time to share their experience.

My family member is 68 and his PSA has been around 3.5–4.2 over the past 8 months, with free/total PSA around 0.15–0.17. An MRI in January 2026 showed an 8 mm PI-RADS 3 lesion in the peripheral right zone, while a repeat MRI in August 2026 showed a lesion extending in an arc along the peripheral-zone edge for about 20 mm, now classified as PI-RADS 5, with more restricted diffusion. The prostate volume is 27 cc, and neither MRI showed extracapsular extension.

The urologist recommends a transrectal fusion biopsy due to the location of the lesion. I'm a bit worried about the possibility of infection/sepsis, so should we find a center that does transperineal rather than transrectal biopsy instead (In my country, fusion-guided prostate biopsies are generally performed using the transrectal approach)? Should systematic cores be taken as well as targeted ones, and how many of them in total? I would also like to know whether there are any infection-prevention measures I should make sure the clinic uses. Is a rectal swab test needed beforehand?

Public Service Announcement for anyone avoiding Pelvic Floor therapy, here's your recommendation to go anyway.

I've been doing Kegels wrong for a year and didn't know until I saw it on the ultrasound. 🤦🏻‍♂️

Super awkward and weird to have a woman ultrasound your taint, but it was really worth it to know what I was doing wrong.

After showing my dick to doctors every 5 minutes it felt like last year, this was nothing.

Was wondering why I was still leaking a little and it was because I was clinching absolutely wrong even though I thought I followed all instructions clearly.

I finally had a no contrast MRI of prostate with post processing done as I have a 110 cc at 9.2 vs in the sevens some years ago when it was 90cc. Fortunately everything seems ok. It was put off as I couldn’t find this type of MRI service until recently.

Did an EpiSwitch PSA a few months ago which suggested a high likelihood of cancer. But it seems the test is subject to errors.

Posting to just give some hope that not all high numbers mean cancer.

My 64 year old husband had an MRI at the end of july because he still had pain from a fall a year ago. The MRI showed bone lesions and something infiltrating the bone marrow. He then had a blood test which showed PSA levels at 744 and Alkaline phosphatase at 2182. He then had a PET scan which confirmed cancerous cells in the prostate and extensively in his bones. We saw a bone surgeon who said he has a mirels score of 10 but he needed to wait for the biopsy results before the first hip replacement.

Today was the biopsy and we get the results after 14 September.

We're exhausted. And scared.

I don’t really know what I am asking for here. I guess just maybe advice, thoughts, or I guess a reason to stop spiralling.

Basically my family just found out that my dad may (most likely does) have prostate cancer.
He’s a 56 year old firefighter and went for one of those “full body” check-up scan things that his job started offering under coverage. One thing led to another and we found out his PCA level was a 300.

He hasn’t been having any symptoms but of course a number that high meant he needed to go for an MRI and we just found out that there was something there the doctor didn’t like and that he’ll now need to get a biopsy.

I am very very worried and scared for him. According to the research I’ve done, that PCA score is extremely high and likely means the situation is not good. We also know that prostate cancer is classified as a disease that he’d be more likely to get because of his occupation.

At the same time, parents have a 2-week Scandinavian cruise booked that they are supposed to leave on this mid-September.

I guess I am just stressed because what if it is something that he needs treatment for right away and they have this cruise they are going on. My mom doesn’t seem to think that 2 weeks will make that big a difference but I’m still worried. He hasn’t booked the biopsy yet and I think he’s also thinking about just scheduling for after they get back instead so he doesn’t have to deal with the healing before they go.

I have just been completely spiralling and going down rabbit-holes and I really don’t know what to do. If anyone has any helpful thoughts, advice or even just some positivity I would really appreciate it. :(

EDIT: Thank you so much for all the advice and kind words. It really helps a lot <3

Husband (56) had surgery June 4th. Gleason upgraded from 7 to 9 after final pathology. He just did his first PSA and it came back at 0.04. Is this considered undetectable? ChatGPT said it was concerning, Google AI said it was okay. Should I be concerned? He is supposed to do his next PSA in 3 months and will be talking to the urologist again after that. The lack of certainty with this disease is very unsettling for us both.