Hearing the words "prostate cancer" is a shock, even if you were half expecting them. It is normal to feel anxious, numb or unable to take in what was said. The good news is that most prostate cancers are found at an early stage, and there is usually time to understand your situation before making any decisions.
Take a breath
Prostate cancer is rarely an emergency. For most men, the weeks after diagnosis are a time to gather information, ask questions and think about what matters to you. Decisions made with a clear understanding tend to be decisions men feel comfortable with later.
It is also normal to need to hear information more than once. Many men remember very little from the appointment where they were told.
Understand your results
Your diagnosis will usually be described using three key pieces of information:
- PSA level: the amount of prostate specific antigen in your blood.
- Gleason score and Grade Group: how aggressive the cancer looks under the microscope. Our guide to Gleason scores and Grade Groups explains these.
- Stage: how far the cancer has grown and whether it has spread. Our guide to TNM staging explains the letters and numbers.
Together, these place the cancer in a risk group: low, intermediate or high. NICE guidance on prostate cancer uses these groups to guide treatment recommendations.
Ask your team to write these details down for you, or request a copy of the clinic letter.
Further tests you may need
Depending on your risk group, you may be offered further scans to check whether the cancer has spread. These can include:
- a bone scan
- a CT scan
- a PSMA PET scan, which is more sensitive for small areas of spread
Men with low-risk cancer often do not need these.
Who will be involved
Your case will usually be discussed by a multidisciplinary team, which brings together urologists, oncologists, radiologists, pathologists and specialist nurses. A clinical nurse specialist is often your main point of contact and can answer questions between appointments.
Understand your options
Treatment choices depend on your risk group, general health and personal priorities. Main options include:
- Active surveillance: close monitoring for low-risk cancer, with treatment only if needed.
- Surgery: removing the prostate, most often by robotic prostatectomy.
- Radiotherapy: often combined with hormone therapy for higher-risk disease.
- Focal therapy: treating only part of the prostate, in selected men.
Our prostate cancer page outlines each one.
Prepare your questions
Writing questions down before appointments helps you get the most from them. You might ask:
- What is my risk group, and what does it mean?
- Which treatments are suitable for me, and which would you recommend?
- What are the likely side effects of each option?
- How long do I have to make a decision?
- Who can I contact if I have more questions?
Our article on essential questions to ask your prostate cancer surgeon has more ideas.
Bring someone with you
A partner, relative or friend can take notes, ask questions you forget and help you talk things through afterwards. Some clinics also allow you to record the conversation.
Look after yourself
The weeks after diagnosis can be emotionally demanding. It may help to:
- talk to people you trust about how you feel
- keep to your usual routines where possible
- stay active, eat well and get enough sleep
- limit time spent reading unreliable sources online
Prostate Cancer UK runs a specialist nurse helpline for men and families who want to talk things through.
Consider a second opinion
Many men find it reassuring to hear a second specialist view before deciding on treatment. This is a normal part of care and should not offend your current team.
Professor Prokar Dasgupta sees men soon after diagnosis, and for second opinions, at The London Clinic, 145 Harley Street. Please contact the clinic to arrange a consultation.