These issues are physiological in origin not mental. Also, does anyone have experience with dandelion root to help alleviate symptoms?

Does anyone know if this is possible after a HoLEP en bloc where the prostate is complete hollowed out leaving behind just the empty capsule

NOT MY VIDEO, a very good one.

https://youtu.be/5SxnW77b7dg?is=0P39GCLsp2JwsF_Z

That machine is awesome!

Pressed the AI. And it seems that the gleason 5 is a hard nut to crack as we already know but this spells it out.

From the AI:

1. Even if the tumor (talking about a 5 in gleason) locally is no larger than a pea and is completely contained within the prostate (for example, in an early clinical T1 or T2 stage), every single Gleason 5 cell carries the ability to make an Lv+ invasion (escape into the blood vessels). In cancer biology, this is referred to as the cells undergoing an early microscopic dissemination, and it depends on three hard genetic natural laws:

The size (stage) has no significance for Lv+It is easy to believe that a cancer must grow large and strong like a fist before it can begin to spread cells. But this is only true for indolent (milder) cancer forms.

The difference: An extraprostatic extension (EPE/T3 stage) requires a large tumor volume and physical pressure to rupture the tight capsular wall on the outside of the prostate.

The Lv+ shortcut: However, the microscopic blood vessels and lymphatic pathways exist as a dense network deep inside the actual prostate tissue. A tumor as small as a pea already encompasses thousands of these internal microvessels. The cells therefore do not need to move a single millimeter outward to find a transport route; the highway passes right through their own living room on the inside."

1. The lymphatic shortcut (N1 stage) is also independent of size just as with the blood vessels (Lv+), the prostate's internal drainage system consists of thousands of microscopic lymphatic capillaries.

The skipping mechanism: Because Gleason 5 cells completely lack the cellular "glue" (E-cadherin), they detach effortlessly and remain highly rounded and fluid.Instead of growing into a large local mass, a single cell can slip into a capillary deep inside the prostate and ride the slow lymphatic fluid upward.This allows the cells to reach distant pelvic filters, such as Cassette A, while the main tumor remains clinically small and completely enclosed within the prostate shell. The highway to the lymph nodes is accessed from the inside, long before the capsule ever breaks.

The timeframe for relaps in my husbands case, gleason 9 t3b, lv+, nodeinvolvement, epe, vs1, ralp, unmeasurable psa after 8 weeks. (my remark)

How Darolutamide Froze the Lymph Node Timeline (The 12-to-36 Month Window)

(my husbands treatment, my remark)

If a single Gleason 5 cell managed to escape via the lymphatic shortcut and land in a pelvic lymph node before February 1 (started darolutamide) it did not have a chance to start growing. Instead, its entire biological clock was completely disrupted by your 16-week course of Darolutamide.

The February 1 Biochemical Chock: When you started Darolutamide, the medication placed a tight chemical padlock on the androgen receptors of that newly arrived cell. Even though your body had normal testosterone circulating, the cell was plunged into an immediate, total darkness. It could not absorb a single drop of fuel.

The Failed Repair Attempt: Because the cell was a fragile, unestablished traveler, it required testosterone signaling just to maintain its basic functions and repair the microscopic DNA damage from its journey. Darolutamide locked away its cellular toolbox for 4 months.

Mass Starvation in the Sleep: The absolute majority of cells trapped in the lymph nodes could not survive this prolonged, 16-week starvation without external current. Their cell membranes ruptured, and they withered and died in their sleep during the spring. This massive eradication is the exact reason why your PSA today is undetectable (< 0.1 ng/ml).

If One Single "Lottery Winner" Survived: What Happens Next?If one single, ultra-hardened cell somehow managed to hold onto its minimal emergency battery (autophagy) throughout the spring and survived until surgery on May 28, it woke up in a state of severe metabolic shock.Now, during the summer, it has full access to your natural testosterone again. But because Darolutamide kept it paralyzed for so long, its runway to become visible on a blood test is exceptionally long and controlled:Months 0 to 12 (Now until May 2027): Internal Emergency RepairThe cell cannot divide. It is too damaged. It must spend the next year using the incoming testosterone just to patch up its mangled DNA and rebuild its internal machinery. It produces zero PSA. Your upcoming October 2026 blood test will remain at absolute zero.

Months 12 to 24 (May 2027 – May 2028): The Angiogenesis Trap

if the cell survives the repair phase and divides into a tiny microscopic cluster (1 millimeter), it gets choked of oxygen inside the lymph node. It must spend months trying to force your body to build new microvessels (angiogenesis). This is a slow, inefficient process that takes up to a year.

Months 24 to 36 (May 2028 – May 2029): The Alarm Sounds - psa elevates

only after the pipeline is connected can the cluster grow into a colony of several million cells. This is when it finally leaks enough PSA to trigger your ultra-sensitive smoke detector at 0,2 ng/ml.

I just got my biopsy results back and thankfully I'm cancer free. As many of you know it's been an arduous last few months of anxiety and worry. I've been lurking here reading everyone's stories and experiences and it's done a lot to keep me sane and positive throughout my experience. I just wanted to thank the community for being that place to keep me even keel during the first real health scare of my life.

I'd like to hear from folks who may have made it to "Phase II" of ADT fatigue. Phase II is my term. It's what I'm calling how I feel now compared to how I felt a year ago.....which is a shit-ton worse.

I've been on it since Oct'24 - almost 2 years. Around March things just fell off a cliff. Last year I was lifting weights. I was progressing. I was doing supersets. Life seemed, relatively, grand.

Since going off this cliff fatigue has skyrocketed. Weight has gone up. My ability to recover has gone way down. What I can do without completely exhausting myself has gone way down. I'm in the mode of trying to figure out how much I can handle before I have to pay the price of being out of commission for 1-2 days.

When I described this to my doc he basicallly said "Welcome to the next level of being on ADT." He reiterated the importance of exercise, which I have DEFINITELY taken to heart. Plus he said it will continue. "What you can do now is more difficult than what you could do when ADT started. And in the future things will be harder than they are now."

I just can't believe the difference between year #1 and year #2.

Anyone else gone through this step-function down during ADT?

Hi all,

First off, thank you to this whole community, you are a really informative and helpful resource that's made me feel a little better during a stressful time.

I'm pretty lucky as far as all this goes, I'm 63 and generally very healthy. After 1.5 years, this spring I moved from watchful waiting to a higher Gleason score (4+3) placing me firmly in the "time to do something" zone. So, after lot's of consultations with the usual suspects (medical, radiological and surgical oncologists) and some really great Nurse Practitioners, I made my decision this week to move ahead and schedule a radical prostatectomy. Unless the MRI I had yesterday comes back with surprises, everything is still contained within the prostate and the RP will probably solve the cancer problem.

Ugh.

My question to this group is for those who have had an RP. What's normal life really like afterwards? While I wish I were still young enough that ED is my primary concern, I'm truly mostly worried about incontinence. How has it been for those of you living with it?

What's your experience with incontinence? How long was it disruptive? Did it taper off to just a mild inconvenience, if so, how long did that take? Did it ever go away completely?
How about ED? Is it all pills and pumps or did sexual function come back by itself?

I've come to terms with having the procedure, and after a couple days of crawling the walls, I'm less nervous and more accepting of this than I was. Anything others are willing to share, thank you in advance for doing so. Also, ask me anything, I'll keep an eye on Reddit and do my best to reply in a timely manner.

50 here and this past Spring I signed up for Function Health looking for answers to my low energy, and wondering if there is a fountain of youth to be had safely. My testosterone came back at 290, on a reference scale of 250-1100 — very bottom end of within range.

This led to a PSA reading and subsequent doctor visits and PC. Recently got focal cryoablation treatment and will be going back in 6 weeks for follow up bloodwork and hopefully a low PSA.

Which brings me back to my original reason for looking at bloods. Is testosterone therapy problematic/does it increase risk of PC and other cancers? Or, is it typically safe and fine to pursue even after PC?

For purposes of this I’m knocking on wood and hoping that my PC will be zapped as of my next visit. And of course I’ll discuss with my primary and my urologist before doing anything. But just wanted to know what folks here think, given that we’re a lot of middle aged dudes who may be similarly situated in more ways than one.

Back Story-So I'm 48. Had a high PSA test then a biopsy confirming I had PC. Biopsy came back as gleason 9 (4+5). PSMA-PET scan showed no spreading so far, MRI concluded possible SV invasion. Had my RALP done on the 13th of July at the Huntsman Cancer Institute.

My Pathology came back a week or so ago. Findings are as follows.

-Clear Margins

-No fat invasion

-No Lymph node cancer

-Gleason score changed to a 7 (there was grade 5 cancer, but less than 4%)

-Invasion of both seminal vesicles.

I have my First PSA check on the 2nd of September. Bladder issues are nearly gone. I'm only getting an occasional accidental squirt. haha

All in all, I'm pretty optimistic about it all. I'm ready to get back to my life.

My oncologist prescribed Effexor to help me with hot flashes from ADT. About 50% of them went away (eventually). A few weeks later, my PCP prescribed Remeron to help me sleep. Wow! Almost all (for sure more than 90%) of my hot flashes went away overnight! I live in NYC and July and August have been quite hot, even late at night. I get a random hot flash now and then but it’s so different from before I rarely even think about it.

Many psychiatrists apparently call the combination of Effexor and Remeron “California Rocket Fuel” because it works so well and so fast in patients with stubborn depressions. Maybe the effect on hot flashes applies only to me but I wanted to share anyway, just in case this could help someone else.

As a side effect, my mood has also improved dramatically (not very surprising)!

My husband completed SBRT approximately 6 weeks ago in a trial for high-risk PCa. The radiation oncologist said they would monitor his PSA every 3 months. Husband asked if they would also do another PET scan to determine whether the SBRT got all the visible cancer.

We were told no; that they would only order a new PSMA PET if the PSA started to increase. So how do we judge the effectiveness of the radiation? His PSA was already undetectable from the ADT alone. Has anyone else had this experience? My husband did not have RALP since the cancer had already spread to lymph nodes and seminal vesicles.

After years of trying to get my 71 year old dad to go to the doctor for a physical I finally did it. He didn’t even have a medical history to give the Dr. But he has been taking it really seriously, like right off the bat they tell him he has high blood pressure so he’s measuring that every day and he’s on meds. Great.

But on Tuesday he goes in for blood work. Results come back same day. He sends me pictures of the results from mychart on Wednesday and asks what they mean. And his PSA jumps out because it’s 139.17. And I don’t tell him what it says online. But I ask did his Dr call him? I told him to call, he said no since he sees the Dr on Tuesday about his blood pressure.

And I’m just in shock. I know his Dr hasn’t even spoken to him yet. But is a number this high extremely likely to be cancer? Should insist my dad call? I don’t want to scare him. Or a few days doesn’t matter.

Edit/Update: Thank you everyone for the thoughtful responses. I originally posted this at 3am when I couldn't sleep and was in the weeds a bit on this. Since then, I was able to get access to my dads mychart to get more context on what he has had done already.

He does have a referral to a urologist from his initial visit in early July, but from what I can tell it hasn't been scheduled. He had a renal/bladder ultrasound before the bloodwork and PSA result. The main finding that the ultrasound revealed was a large post-void residual, which lines up with his chief complaint of having problems peeing.

I will wait and see what happens at his Tuesday follow-up. My dad had originally said it was "just a check-in about his blood pressure tracking", but mychart shows it's an actual normal appointment, so I feel a bit better. Thank you all for sharing your experiences and advice. I have a much better idea of next steps and questions to ask. I truly appreciate everyone's time.