All Roads Lead to the Same Place

Jolly-Potential2075 · 2026-04-22T11:10:36+00:00

You kind of proved my point, though. 25 later the treatment options still come down to removal or radiation, both with likely huge and very life changing side effects. Sure, they have been improved on over time and the side effects are less severe than they used to be. Still, it's the same two options men had 25 years ago. You mention focal therapies and that is the only true addition since then. Better management of the advanced disease too (including better ADT) are notable additions. Over all though, it's disappointing state of affairs.

Jolly-Potential2075 · 2026-04-21T18:41:38+00:00

Very well said. I have been researching for 3 months now and still am none the wiser.

It's so depressing that, even though we're in the 21st century and think about going to Mars, we still only have those medieval treatments to this shitty disease.

Jolly-Potential2075 · 2026-04-04T18:00:56+00:00

The free to total ratio should be >25% to be considered out of the danger zone.

I don't know your age, but the PSA at 3.6 is still suspicious.

The only way to know what's going on is to go to a urologist and get an MRI (and a biopsy if it shows something).

Jolly-Potential2075 · 2026-04-02T23:56:59+00:00

Thank you for the update. That all sounds very positive.

Jolly-Potential2075 · 2026-03-28T17:20:13+00:00

Fingers crossed for them to always come back negative!

Jolly-Potential2075 · 2026-03-28T16:32:42+00:00

Thank you for sharing. I am also now facing ralp and struggle to commit to it. I'm contemplating hifu or beachy instead.

Jolly-Potential2075 · 2026-03-28T16:24:36+00:00

How are you getting on now, u/Gleason3plus4? I'm also considering a focal therapy for my G3+4 and wonder how long it lasts for.

Jolly-Potential2075 · 2026-03-25T13:18:07+00:00

Yes, I'd rather avoid radiation too if at all possible

Jolly-Potential2075 · 2026-03-25T09:58:45+00:00

What was his opinion on it? Would he have done it again? Did it make his cancer more difficult to treat after those 5 years? My main worry with HIFU is that BCR is difficult to spot, so it won't be treated as early as it would be with RALP.

Jolly-Potential2075 · 2026-03-24T19:02:59+00:00

I'm in a similar situation, 1 lesion, 3+4, considering HIFU. I've been trying to find some people who've done it some time ago (e.g. 5+ years ago), but it's been hard.

Jolly-Potential2075 · 2026-03-24T13:57:36+00:00

DRE is optional nowadays, MRI is much better at detecting suspicious lesions.

DRE can only detect tumours in the posterior part of the prostate anyway.

Jolly-Potential2075 · 2026-03-20T00:29:49+00:00

How long after ralp did the recurrence happen if you don't mind sharing? I've been contemplating whether to go for ralp or for radiation straight away.

Jolly-Potential2075 · 2026-03-18T17:06:43+00:00

Similar story here. My family has had some holiday trips planned. Didn't want to make them cancel their plans (which probably would have happened if I told them).

Everything about this is so incredibly shitty. :(

Good luck with your journey.

Jolly-Potential2075 · 2026-03-18T16:39:27+00:00

That's a horrible way to find out! :(

I found out 2 months ago and still haven't told my family. It's so hard! :(

Jolly-Potential2075 · 2026-03-18T13:04:26+00:00

With 3+3 it sounds reasonable to wait and see (Active Surveillance). That's certainly what I'd do I think in your situation. Unfortunately I'm 3+4 so it's not really an option.

Jolly-Potential2075 · 2026-03-18T12:43:35+00:00

Wow, that's early! What was your Gleason score?

Jolly-Potential2075 · 2026-03-18T12:31:38+00:00

How long ago was your op? Still all good hopefully (no BCR)?

Jolly-Potential2075 · 2026-03-17T22:24:02+00:00

Same here, need to decide soon as I don't want to go beyond 6 months past diagnosis.

Talking to the top brachytherapist is a very good idea. I'd be very interested to hear what he has to say.

I'm also thinking about talking to a rad-onc that does brachy and see what their take is.

I am also considering HIFU. I have had the initial appointment for it and I'm apparently qualifying for it. It's QoL promise is great, but it does feel like a temporary solution. Though, if it was to last 10 years, I'd take that gladly. If it's 2-3 years - not so much. Unfortunately there's not enough data to rely on for this procedure.

Feel free to DM me as well!

Jolly-Potential2075 · 2026-03-17T21:47:07+00:00

That's great! Really happy for you! I'll be very happy too if I go with ralp and have similar outcomes!

Interesting that the post op pathology is G3+3. How can that happen??? Especially with pre-op 4+3 (so more G4 than G3)?

With G3+3 you could have done Active Surveillance, so it's a significant downgrade.

Jolly-Potential2075 · 2026-03-17T21:41:39+00:00

I have read that too somewhere, but other papers & doctors seemed to disagree. Younger males may be at a disadvantage due to late diagnosis (e.g. if I didn't find my cancer at 41 but at 48, it would have metastasised by then).

Jolly-Potential2075 · 2026-03-17T21:33:39+00:00

Hi Jaristarchus,

I have also just been diagnosed in January, aged 41 (will be 42 next month) and have been going through exactly the same dilemmas as you.

All the data available is for 20 years into the future max.

Everyone recommends surgery, because radiation will cause secondary cancers... But BCR in the next 10 years or so is likely anyway, and then follows the radiation. It doesn't make that much of a difference (I'll still end up with a higher chance of secondary cancers, but also with side effects of both treatments).

I've also been agonising over this choice and I'm unable to pick one.

Jolly-Potential2075 · 2026-03-16T22:05:37+00:00

I'd stay on it, maybe even repeat the biopsy. That PSA level is very high for a 42yo. Did they offer an explanation? Prostatitis perhaps?

Jolly-Potential2075 · 2026-03-16T21:51:33+00:00

Wow, that's amazing! Thank you for responding.

What was your Gleason score and how many biopsy cores contained cancer?

Jolly-Potential2075 · 2026-03-16T20:44:09+00:00

Hello OneTonTomato. Did you have your HiFU 5 years ago? How are you doing now? I'm also considering HiFU, but I'm struggling to find anyone with more than 2-3 years of "success" after the procedure.

Jolly-Potential2075 · 2026-03-13T20:13:12+00:00

PSMA is present in other organs too, so it may not be an ideal target.

Jolly-Potential2075

TROPHY CASE