FAQs

We encourage you to have honest, open discussions with your doctor. Here are some questions you might want to ask. Print them and carry them with you during your next visit to the doctor. Be sure to add your own questions as well.

Questions about your initial evaluation

  • I am (age) - what should I have done to check the health of my prostate (check the PCFA policy on PSA and DRE to check our recommendations)
  • What is my prostate specific antigen (PSA) value?
  • Is my PSA value normal for my age?
  • How does this PSA value compare to my PSA values in previous years?
  • Should I have a repeat PSA value in a week or more?
  • How reliable is the PSA and DRE and what do these results tell us?
  • Did the digital rectal exam (DRE) give indication that there may be reason for concern?
  • What do you recommend that we do next?
  • Should I follow a special diet/ take other steps with my lifestyle for
  • What impact does family history have on my likelihood to return a high PSA result? Given that my father and/or uncle have succumbed to prostate cancer.

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Questions about your follow-up examination

  • What types of follow-up examination do you recommend, and what will be involved?
  • My PSA test shows an elevated reading - should the test be repeated?
  • Have we collected multiple PSA values over time so that we can determine if my PSA level is rising? If so, how rapidly is it rising?
  • Will you recommend a biopsy and why - what is involved
  • Will you be recommending a bone scan?
  • Will you want me to have a CT scan or an MRI, and if so why?
  • Will you require me to have an ultrasound test on my bladder full and empty to check out flow rate and retention?

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Before biopsy

  • Where will the biopsy/bone scan/CT scan/MRI take place?
  • Will I have to go to the hospital?
  • How long will it take? Will I be awake?
  • Will it hurt? What are the risks?
  • If there is a concern about the length of time in getting a biopsy/bone scan/CT scan - can I go to another hospital to get it done?
  • What are the chances of infection or bleeding after the test?
  • Make sure the urologist provides a prescription for an antibiotic course prior to the biopsy to prevent infection!
  • How long will it take me to recover?
  • How soon will I know the results?
  • If I do have cancer, who will talk to me about the next steps? When?

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You’ve been diagnosed with prostate cancer

  • What’s the diagnosis?
  • Would you please write down the exact type of cancer I have?
  • May I have a copy of my pathology report?
  • Please explain what the Gleeson score is and how my score was calculated?
  • What was the grade of the cancer? What does this mean in my case?
  • Do you believe that this cancer is in the prostate or could it have spread to the lymph nodes/other parts of my body ? If so, is it still curable?
  • Do you believe this cancer is curable?
  • What did the bone scan/CT/MRI show?
  • What additional tests do you recommend and why?
  • Do you believe this cancer will spread if it is not treated -- and if so how fast?
  • Given my PSA result and combination of GLEESON score, how would the mathematical model nomogram based on1000s of previous patients describe my prognosis?

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Questions to help you choose the right treatment

Many specialists talk in percentages of the likelihood of having erectile dysfunction, loss of libido, impotency, incontinence, anal bleeding and other side effects from treatment. It is very hard to grasp and understand these issues when you have just been told you have cancer, these questions may help you form your own opinions all the information available!

  • There are different approaches to prostate cancer. These questions may help you to choose the best option to suit your needs.
  • What treatments might be appropriate for me? What are the benefits of these treatments?
  • How does my age, general health and other medical conditions affect my treatment options
  • Among those treatments, what are the risks or side effects I should expect?
  • What are the costs of each treatment - and what can be claimed through Medicare or a health fund?
  • What are the chances that I will have problems with incontinence or impotence?
  • Will I have other urinary or rectal problems?
  • What are the chances of the cancer coming back with the treatment you suggest?
  • What other treatment(s) might be appropriate and why?
  • What is my expected survival rate based on clinical stage, grade, and various treatment options?
  • What do I need to do to prepare for treatment?
  • Is watchful waiting a reasonable course of action for me?
  • I would like to explore other treatment options and speaking with other specialists before deciding upon a final plan of action - can you help me with this?
  • What sort of assistance will I need to help me cope with treatment
  • Can I continue normal activities during treatment?
  • What can I do to improve the success of my therapy?
  • What kind of follow-up can I expect after treatment?
  • Are there any long term effects of treatment
  • Are there dietary changes that I could or should make to optimize my treatment?
  • Should I join a clinical trial?

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You’re considering watchful waiting:

  • If I choose watchful waiting, can I change my mind later on?
  • Will the cancer be harder to treat later?
  • How often will I have checkups?
  • Between checkups, what problems should I report?

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You’re considering surgery

Knowing what to expect before, during, and after surgery for the treatment of early-stage disease will help you make the best decision for you.

  • Which surgical technique will be used?
  • Based on your experience, why is this the right approach for me?
  • Do you believe radical surgery is appropriate in my case? What is involved?
  • Do you think that cryosurgery or other investigational techniques may be appropriate in my case?
  • Do you plan to employ a nerve-sparing technique with the aim of conserving my ability to get an erection following surgery?
  • Who will actually operate on me if I elect to have surgery?
  • How many operations of this type do they do in a year?
  • What level of success is there in preserving potency (ability to get an erection) in your patients following surgery?
  • What about preserving urinary continence (bladder control)?
  • What will you do if you find cancer outside of my prostate during the surgery?
  • Will that change my prognosis and future treatment?
  • What can I expect following the surgery in terms of recovery time? How long will it be before I can return to my normal activities?
  • What are the likely or possible side effects of the surgery, both short-term and long-term?
  • If I have pain - how can I control it?
  • What will we do to monitor my prostate cancer following the surgery?
  • Is there someone I can talk to who has had this surgery?

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You’re considering radiation therapy

Knowing what to expect before, during, and after radiation therapy for the treatment of early-stage disease will help in the decision-making process when choosing the best therapeutic strategy.

  • Which radiation technique will be used?
  • Based on your experience, why is this the right approach for me?
  • How will this procedure precisely target the cancer tissue but leave the normal tissue unharmed?
  • Do you believe external beam radiation therapy is appropriate in my case?
  • Do you think that brachytherapy or radioactive seed implantation may be appropriate in my case?
  • Is it true that brachytherapy is not covered by Medicare or many Private Health funds?
  • Who will actually do the radiation if I choose this path?
  • What dose of radiation will you be using and how/why did you select that dose of radiation?
  • How often will I need to come into the clinic for treatments?
  • Do you recommend that we initiate androgen deprivation therapy ("hormone therapy") before the radiation treatments? Why or why not?
  • What level of success have you had in preserving potency (ability to get an erection) in your patients following this type of radiation therapy?
  • What about preserving urinary and bowel continence (bladder and bowel control)? Are there other urinary or bowel side effects that I should be concerned about?
  • What can I expect following the treatments in terms of recovery time? How long will it be before I can return to my normal activities?
  • Are there delayed side effects that might appear over time?
  • What will we do to monitor my prostate cancer following the radiation?
  • Is there someone I can talk to who has had this treatment?

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You’re considering hormone therapy:

  • What kind of hormone therapy will I have?
  • When will treatment start? How often will I have treatments? When will it end?
  • Where will I go for treatment? Will I be able to drive home afterward?
  • How will I feel during treatment?
  • What can I do to take care of myself during treatment?
  • How will we know the treatment is working?
  • What are the side effects ?
  • Will there be lasting side effects?

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Questions about treatment effects and follow-up

  • After treatment, what sort of problems should I expect and allow for?
  • What can be done to manage the side affects of treatment
  • Should I expect problems related to bladder control, and if so for how long?
  • Will I still be able to have a normal erection? Will I recover a normal erection after a period of time?
  • If I have problems with incontinence or recovery of a normal erection, how long should I wait before we discuss the available treatment options?
  • If the definitive treatment fails, and my PSA starts to rise again, what would you recommend at that stage?

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Your PSA Is Rising during or following treatment and advanced prostate cancer

  • Since my PSA is rising again, do we discontinue the treatment? Why or why not?
  • Are there additional hormone therapy approaches that we should explore?
  • Should I get a bone scan to determine if the cancer has spread to my bones? What will the bone scan tell us?
  • Are there therapies that might help slow down the disease progression, especially to prevent the spread of the cancer to my bones?
  • If there is evidence that the cancer has spread to my bones, how can we treat it, slow down the progression and/or prevent bone pain?
  • What are all of the treatment options available to me at this time?
  • Is it important to consider the sequencing of treatment options so that we preserve as many options as possible in the future? Are you recommending any treatments that might prevent me from qualifying for a clinical trial in the future?
  • When should I receive bone strengthening drugs to compensate for the loss of bone density due to continued use of Androgen Deprivation Therapy?
  • Do you believe in early or delayed hormone treatment for advanced prostate cancer?
  • Do you believe that combined hormonal therapy offers benefits compared to surgical or medical castration for advanced prostate cancer?
  • Should we consider chemotherapy?
  • What other treatment(s) might be appropriate and why?
  • What are the side effects of the treatment plan that we have selected?
  • Are there dietary changes that I could or should make to optimize my treatment?
  • Are there any other specialists that we should or could add to my treatment team to gain an additional perspective on treating my disease?
  • Should I consider joining a clinical trial?

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Advanced Prostate Cancer - Questions for your doctor

  • What can be done to stop bone density loss?
  • How long have I got to live?
  • Will it be painful?
  • What is palliative care? Where can I get information?

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Advanced Prostate Cancer - Questions for you, your family and friends

  • How can I keep my energy levels up?
  • How should I react to all the those who offer advice on everything from vitamin supplements, alternative medicine, diets, no alcohol, religion, spirituality, meditation and uncorroborated stories about other prostate cancer sufferers, etc
  • Who can help or assist me to write a basic autobiography for my family?
  • Is there anywhere that Advanced Prostate Cancer sufferers can find others in a similar situation?
  • How should my adult sons and relatives be educated in their likelihood of contracting/ developing the disease?
  • Loss of sexual ability can play on a man’s mind and knowledge - that it is unlikely to return in advanced cases can be devastating, nevertheless it can lead to greater intimacy with your partner. Where can I gert information and support with this?
  • How do you stop people dwelling on imminent death?
  • When should I upgrade my “WILL”, “Power of Attorney” and “Enduring Guardianship” documentation?
  • When should I consider refining and simplifying all my financial affairs including superannuation, taxation, investments, property and other assets?

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