Had RALP 4 months ago and urologist has me on 5mg daily Cialis. Bilateral nerve sparing was performed. Gleason 7 with cribriform pattern unfavorable intermediate was the diagnosis. Pre surgery I had some mild Ed issues and would take cialis only before sex. Now it is very difficult for me to get hard and maintaining an erection is near impossible. Still getting used to the dry orgasm and not sure if I ever will. My doctor says just give it time but I feel like i had some immediate improvement then plateau at a place that is not where I would like. Have not experimented with any other ED/penile recovery methods. Anyone else in a similar age range who has dealt with or is dealing with ED post op?

Newly diagnosed and every damn thread on here has tons of acronyms which might be fun for you but really suck for anyone new. GAGABF (Give a guy a break, folks.)

EDIT: found this helpful https://connect.mayoclinic.org/discussion/prostate-cancer-related-abbreviations-what-acronym-would-you-add/

To the oncology medical community:
Writing to voice my concern about caretaker & family support while a patient is on Lupron medication. There have been significant psychological impacts causing family strife & separation, abusive behavior, aggressive behavior towards others, as well as paranoid behaviors, poor decision making capabilities, extreme improper financial decisions, & communication issues. There are extreme & heightened personality issues. These symptoms are known by the medical community when a patient is on Lupron but there has been no notification to the patient or his family to beware. We were unaware & unprotected by these behaviors. We have feared for our safety & for others. Behavior is uncontrollable.
There may never be recovery from these behaviors. These symptoms are known by the medical community when a patient is on Lupron but there has been no notification to the patient or his family to beware. We were unaware & unprotected by these behaviors. We have feared for our safety & for others. Behavior is uncontrollable.
There may never be recovery from these behaviors. Families need to know this but someone is trying to shut this information down. I further believe this is the reason behind the trans gender violence. No one wants to talk about it. This medication is unsafe.

Dr said nerves were spared and everything went well (vague, he reported to family, had 3 and I was first of the day) but I didn't see him. Follow up after removal of catheter (i catch the second weekend on day 10, fml).Just had a few questions from your experiences. For reference 44yo gleason 6, 5/12 cores high percentage and intermediate decipher. No spread.

About how long until you received post op pathology?

When do PSA tests come and what am I looking for? .01 or .001?

Did you have these symptoms and when did they subside?

Blood in urine.... Days/weeks?

Feel like I have to go #2 today but afraid to push in the slightest? Feel like im waiting for it to fall out. Have taken mirolax x2 thus far. Going as normal ok or slightest strain a no?

Had awful lower back pain yesterday and this morning. Has subsided. Was the only pain on dilodid. Sent me home day of with tylenol and ibuprofin. Now it's mostly gas or air pain that can suck, pain that travels to back and shoulders (stress?) and very little pain in lats (6 cuts).

Catheter is an annoyance, assuming it gets worse.

All in all not too bad day after.

TIA

Can someone post the proper name of the Squeeze App they recommended and maybe a picture of the icon? There seem to be so many...

I had a yearly routine PSA test and it went up from 2.4 to 3.7. I already had been diagnosed with an enlarged prostate.

Had to wait 3 months to get an appointment with a urologist. They had me do an isoPSA, Total PSA and Free PSA. DRE no lumps

IsoPSA 12.1 PSA 2.7 Cleveland Diagnostics
Free PSA 25.2% PSA 2.4 Quest

Have a meeting next week with the urologist.

My isoPSA indicates an increased likelihood of finding high-grade prostate cancer.

I’m guessing the next step will be a MRI to determine if a biopsy is required.

I guess it’s good to find the problem early, but if I didn’t have that one PSA spike I’d be fat dumb and happy till it spiked again.

This subreddit is wonderful with all the great posts. I’ve been reading people’s journeys trying to choose between surgery and radiation. Unfortunately there doesn’t seem to be one best answer. I never knew how many people suffer with prostate issues. Having an anonymous site to discuss it is great.

Had a prostatectomy at the end of June and my PSA has leveled off at .04 - we started ADT, a six month course, a week ago and will be going into radiation treatment pretty soon. My doctors have suggested we add Abiraterone, a two year course, to the mix to make the largest impact possible right away.
I’m leaning towards it but I understand treatments are complex I just don’t want to make this complicated by doing too much. They say this is an abundance of caution and not a complete necessity at this point - I’m wondering if anyone might share their experience with this drug? Thanks for your input.

Does anyone have experience with Emory Wincship Cancer Institute? Recommendations based on experience? Or do you have another recommendation in Georgia area?

I'm still deciding on which path to take, but slightly leaning toward Proton Therapy if it is an option. If not, then I am looking at RALP (or similar option).

Workouts?

I’m recently diagnosed with Gleason 8 and exploring my options. I’m not 100% there but leaning toward RALP. My original urologist , Dr. Kozin is at Piedmont Hospital. I think he’s a great surgeon if I decide to go that route. I’m concerned about the staff and the hospital. It’s only him and one nurse along with a scheduler . When I’ve had questions it always takes a couple of days to get a response. How important is the team here.
I also met with Multi disciplinary team at Emory. I wasn’t really impressed with the surgeon Dr. Lorentz but like that radiation, medical and surgical oncology are all coordinated. I’m considering getting an appointment there with there top surgeon Dr. Pattaras.
I’m meeting next week with another radiation oncologist at Northside.
All this to ask is there anyone here who has any experience with either of these surgeons or would recommend any Atlanta surgeon or radiation oncologist?

In the case of a BCR, how long did you wait from the moment the doctor ordered the PET-CT scan until you received the results and began radiation therapy?

Had RALP in April 2025, gleason 9 with large cribform present and margin were really close but not over on left side and surgical margin on right side was positive. I had a PSA test every 3 months and everyone of them read <0.01 for the 1st year. Doctor moved the test to every 6 months and had my PSA today come back at 0.02, and has now registered on my graph that my chart keeps. To you guys is this an increase or a possible blip and should I be concerned.

I'll be having a RARP in a couple of months. Surgery will take place in Melbourne but I live in Tasmania, which is an hour flight away (Tasmania is an island south of Melbourne). So, I'll need to fly a day or 2 post op. Obviously I will still have the catheter in place. Has anyone taken a flight so soon after surgery? If so, how did you go?

Edit: I'm having my PET scan on Monday so will catch up with my surgeon after that. I'll ask him what he recommends. No place like home though.

As I understand it, the primary risks associated with SBRT are some very mild secondary toxicity and a more difficult process for monitoring recurrence.

After getting to nadir, how are you being monitored for local or remote recurrence? Is it just PSA or are you getting periodic MRI or PSMA PET scans?

My urologist discussed this with me today and kind of freaked me out, he wasn't pushing surgery and signed me up for a consult but one of his risks associated with SBRT was the difficulty in reacting to a remote recurrence before it advances to a serious issue.

Scheduled for TULSA next Tuesday, but it just doesn't feel right. I've got 5x1 4x2 and 3x3. Gleason 7. Prolaris test says 2% chance mortality in 10 years, 0.8% chance of metastasis. Research is telling me 50% of men do active surveillance. Lokking for feedback before I jump into a procedure out of panic rather than need/logic. Feedback apperciated!

Asking for my dad

His reports are below. We looked at both options RALP and radiation. Dad is inclined towards radiation. We have MRI-LINAC / CT-LINAC and proton therapy option available. Although proton therapy center is not easily accessible and far away in another city. Would most likely be MRI-LINAC or CT-LINAC. Can I get some help on which of these radiaton methods will be better for him and your experiences with them?

PSA

PSA: 4.7 ng/mL

Age: 64

MRI

Prostate approximately 40 × 48 × 48 mm.

MRI showed bilateral transition-zone lesions classified as PI-RADS 3, thought to be related to BPH.

No pelvic lymphadenopathy reported.

No obvious extracapsular extension or seminal-vesicle involvement reported.

Biopsy was subsequently performed.

Biopsy – 14 cores

Cancer was found in 5/14 cores:

Right peripheral base: Gleason 3+3, 20%

Right peripheral mid: Gleason 3+3, 10%, with small focus of perineural invasion

Right peripheral apex: Gleason 3+3, 10%, with small focus of perineural invasion

Right parasagittal apex: Gleason 3+4, 60%, pattern 4 = 10%

Right transition-zone fusion biopsy: Gleason 3+4, 60%, pattern 4 = 30%

Overall:

Gleason 3+4 = 7, Grade Group 2

The remaining left-sided cores were negative for invasive cancer, although there was PIN in two cores.

PSMA PET/CT – September 2026

The scan showed PSMA uptake in:

Right and left peripheral zones at the base

Right peripheral zone at the mid-prostate

But importantly:

No definite scan evidence of PSMA-expressing loco-regional/distant metastases.

This my 1st post here. I have been very impressed over my journey so far with information I have been able get from this group, thank you. Been able to bring educated questions up to my urologist and my oncologist and my own doctor.

I'm midway through prostate cancer treatment and on ADT. My surgeon is scheduling the barrier spacer early November and he's leaning toward the newer barrier balloon (BioProtect) instead of the hydrogel gel. Anyone have any experiences with this product or technique?

How was placement day? (Pain, how long)

How was recovery — back to normal same day or longer? Any issues beyond the placement day?

Any complications?

How did radiation go afterward?

Thank you everyone for your time and your help.

I missed this reading the post operation pathology report, but a second cancerous node was found within my prostate.

I had my 6 week post op appointment with my urologist, and she made me aware of it. If I had gone with a focal procedure this “new” node would not have been targeted. The best case scenario is that it could have been caught before the cancer spread out of my prostate. The worst case, I don’t want to think about it.

My choice to go with RALP was based on that exact scenario presented to me by my surgeon.

Around 3 weeks post RALP I started getting sessions of a severe ache in my legs (hamstring area) and hips. Happens once to twice a day and last about 4 hours each time. I have researched restless legs syndrome and sciatica nerve pain. None these seem to match my symptoms so I think it must be related to my operation. I searched this subreddit and noticed some others have reported this condition in the past.

Seems to happen more in the evenings. Absolutely unable to sleep when it occurs and I get up and groan and go for a walk - walking seems to help a bit.

Concerning the RALP I had 11 lymph nodes removed and 1/4 of nerves on one side removed. Negative margins. I am now 5 weeks post RALP.

Anyone else experience this? Only drug I am taking is 10mg Tadalafil and I stopped for a day and the aches kept coming so I don't think it was the Tadalafil.

67 yo. Starting PSA 50 in February 2026, Gleason 8 (4+4) with cribriform, MRI showed local escape with invasion of external sphincter and contact with pelvic muscles, PSMA PET concluded no metastasis although one spot on the rib is indeterminate however statistically likely benign. CoE team in Boston removed RALP as an option, and recommended multi-modal. Lupron started in April, 23 sessions IMRT with Varian Edge completed early July, 15 Gy HDR bracy end of July, PSA 0.40 at the end of August, started generic Abiraterone with 5 mg prednisone one month ago. Except for the HDR bracy procedure itself (failed spinal block), everything has been well tolerated with only mild fatigue from the Lupron. Until now.

In the last two weeks I have been experiencing increased anxiety and sometimes panic with blood pressure spikes, which I attribute to the prednisone. I plan to demand stopping the prednisone when I meet with my oncologist 2 days from now.

In reviewing Gemini recommendations for possible changes, I am thinking of requesting a change to Nubeqa from abiraterone. Does anyone have advice on better alternatives?

RM DE PRÓSTATA SIN Y CON CONTRASTE

Descripción de la exploración:

RM de Pelvis-Prostática:

Técnica: Se realiza estudio multiparamétrico en equipo 3T mediante secuencias T2 de alta resolución en plano axial sagital y coronal, difusión (B=400,1400), adquisición dinámica multifase tras administración de contraste IV y estudio de perfusión (cualitativo y modelos de farmacocinética). También se realiza adquisición de cuerpo entero T1 tras administración de contraste.

Hallazgos:

Próstata de 35 cm³ con leve hipertrofia estromal y glandular de la zona transicional sin lesiones sospechosas a este nivel. Lesión de 14 x 7 x 10 mm localizada a nivel de la zona periférica segmento posteromedial derecho del ápex prostático con intensa restricción de la difusión y perfusión elevada en relación con neoformación clínicamente significativa. Presenta un amplio contacto con la superficie periférica glandular e irregularidad de la grasa adyacente a la pared anterior del recto que sugiere infiltración extraglandular. La lesión es accesible a la biopsia transrectal.

Vesículas seminales simétricas sin lesiones.

Vejiga normal. No hay uropatía obstructiva. No se aprecian adenopatías pélvicas.

Conclusiones:

Pi-rads 5

---------------------

Ya veis, pi-rads 5. El peor escenario en teoría. Que veis de malo y bueno en esta resonancia? Tenía que haber hecho hoy la biopsia pero me la han atrasado una semana por estar con gripazo y tomando otros antibióticos. Gracias....

My mother is elderly and has heart issues. While I am not worried about recovery from prostate cancer (still deciding which treatment route to take) I am worried about telling my mother. If she had a favorite child it would be me. I welcome any tips from those who have had to tell loved ones, particularly a parent with health issues.

Hey everyone, posted about a month ago and has been a bit of development, just wondering how to interpret the news before I speak to my urologist (they're sending me a letter apparently, thanks NHS)

Quick Stats

• Age: 37
• PSA Timeline:
• July: 4.3 (tested during an ED checkup)
• August: 5.4 (PSA density 0.11) — worth noting this blood draw was done within 24 hours of ejaculation and right after a DRE
• October: Dropped to 3.1
• MRI: PI-RADS 3 (equivocal finding in one area.

What happened

After my first PSA came back at 4.3, I got referred to urology. They repeated the PSA (5.4) and booked me for an MRI. The MRI picked up a PI-RADS 3 finding, and the clinic told me to repeat the blood test in a month.

Around that same time, I started getting some suspected bladder pain and frequent urination. Standard urine cultures and STI panels all came back completely negative. Worried that prostate inflammation or a hidden infection was artificially spiking my numbers and pushing me toward an unnecessary biopsy, my doctor put me on a 2-week course of Ofloxacin. About a week after finishing the antibiotics, I had my repeat PSA done and it dropped down to 3.1.

I haven't had my follow-up appointment with urology to review this yet, but I'm trying to make sense of where I stand.

A couple of things I'm wondering: * Is a drop from 5.4 to 3.1 after antibiotics/time as reassuring as it feels, or am I getting ahead of myself? * If the antibiotics are what helped lower it, but no infection was ever detected on tests, how do I truly know the infection is fully gone? * What is likely to happen next at urology? Will they typically want to repeat the PSA in a few months to ensure it stays level or continues to drop, or do they still tend to push for a biopsy with a PI-RADS 3?

Post radiation guys: do you monitor PSA 3 mo., 6 mo., or 12 mo. intervals? Why?

I wanted 3 months but office is pushing for 6 months.

My TULSA is scheduled for next Tuesday 10/20/26. I always over-analyze, but I've worn myself over whether I've made the right choice. Expecting to have catheter for a week and will have pads for whatever happens. Would love to hear feedback (good or bad) as to whether or not TULSA is a viable procedure and what your results were. I'm 72, PSA was only 5.9, 6 lesions 2x5, 3x4 1x3. Radiation struck me as too many side effects and age made RALP seem like the wrong choice. Feedback? Thanks in advance.