Steps to Take After a Prostate Cancer Everyday Health. Everyday Health MenuNewslettersSearch Prostate Cancer 7 Steps to Take After a Prostate Cancer Diagnosis After hearing that you have prostate cancer, you may wonder what to do next. Here's how to get started on the right path in securing a good prognosis. By Chris Iliades, MDMedically Reviewed by Rosalyn Carson-DeWitt, MDReviewed: April 30, 2018Medically ReviewedIf you've been diagnosed with prostate cancer, don't hesitate to ask questions about your treatment options and seek a second opinion.Mike Harrington/Getty ImagesYour diagnosis of prostate cancer may still be pretty new, and you’re not sure what you feel or where to turn for help. That’s normal. Whatever you’re going through, it’s a pretty good bet that you’re not alone. Many people feel a mix of surprise, confusion, and fear — along with other feelings — when they hear they have cancer. What you can be sure of: Your next few steps after a diagnosis will help shape your prognosis, or how you’ll likely fare with prostate cancer over time. “It's important to remember not to panic,” says Steven E. Canfield, MD, the chief of urology for McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), and the Memorial Hermann-Texas Medical Center. Take the time to get all the opinions you need and to talk to all the people you need, he says. While you may know men who did (or didn’t) do well after a prostate cancer diagnosis, keep in mind that your situation could be entirely different. “Prostate cancer represents a spectrum of disease,” explains Peter Carroll, MD, MPH, professor and chairman of the department of urology at the University of California, San Francisco (UCSF). “Not all [prostate cancers] are the same, and not all need the same type of treatment.” He advises people “not to rush to a decision regarding treatment” and adds that “very, very few prostate cancers require urgent treatment.” 1 Ask These Key Questions About Your Cancer The first tip is to get educated. Dr. Carroll recommends seeking multidisciplinary opinions from experienced providers. When talking to your doctor, it’s a good idea to have other people in the room with you. Friends and family can create a support team that’s often helpful, Carroll explains, since “people hear different things and tend to ask different questions.” Dr. Canfield adds that taking notes when reviewing information on the web is also important because “you are going to see so many things that may or may not apply to your specific cancer; it's so common to forget what you were going to ask the doctor.” To get started, Carroll suggests the following questions, which can help you get to the heart of your situation.How aggressive is my cancer? In most cases, prostate cancer grows slowly; however, some men may have more aggressive forms. There are many ways to assess this. Your doctor may use the Gleason score, which, according to the Prostate Cancer Foundation, is a sum of two scores that ranges from 2 to 10, with 10 being the most aggressive. Most men diagnosed with prostate cancer have a score of 6 or 7. Another approach to evaluate aggressiveness of the cancer is the Cancer of the Prostate Risk Assessment (CAPRA) score, which was developed at UCSF.Do I need to undergo additional imaging? Tests and procedures designed to see exactly where the cancer is in your body are getting more sophisticated and accurate at staging cancer. They include magnetic resonance imaging (MRI), computed tomography (CT), and positron electronic topography (PET). Canfield notes “it’s important to be diagnosed somewhere that has access to the newest technology in imaging.” He says MRI fusion biopsy is one of the newest tools doctors are using, and it stages cancer much more accurately.Should I have my tumor assessed using personalized medicine? Also referred to as genomic profiling and genomic testing, personalized medicine is a relatively new approach that enables cancer experts to build a customized strategy for your cancer treatment based on prostate tumor cells taken during a biopsy. Learning about the unique characteristics of the tumor cells can help in predicting how your prostate cancer in particular might respond to different treatments. Other tools are also available to assess your disease and help predict likely outcomes of different treatments. For example, prostate cancer prediction tools, called nomograms, are available online through institutions such as Memorial Sloan Kettering Cancer Center in New York City. 2 Consider All Your Treatment Options A major question to ask, says Carrol, is “Do I need to be treated?” Between 20 and 40 percent of prostate cancers found in men today are indolent (cause little or no pain), he says, and will either grow slowly or not progress much from where they are now. For many men, an approach called “active surveillance” in place of immediate treatment is a very safe and well-tested option. This could be a good choice if your cancer has not spread, you are older, and your Gleason score is not high. The Prostate Cancer Foundation points out that this popular approach should not be equated with doing nothing. A lot of follow-up is involved in active surveillance when it is done correctly and safely. If you do need treatment beyond active surveillance, Carroll recommends you ask your doctor:What are all my treatment options?If I am treated, what can I expect in terms of cure, survival, and side effects? Carroll notes that all treatments have side effects, and you should understand them well before selecting any one treatment approach.How much experience do you have in these treatment options?In your hands, how have men like me fared with regard to the outcomes discussed? How do you assess these outcomes? 3 Get a Second Opinion Ask your doctor about other providers or centers you might go to for an additional opinion. If your doctor balks at this, Carroll says, you should find another doctor, which you can find through local hospitals, clinics, and cancer centers or through sources like the American Medical Association and the American Society of Clinical Oncology. Men with prostate cancer may be overtreated or undertreated, Carroll says. Specifically, many with advanced prostate cancer don’t get enough treatment, and some men with local disease get too much treatment. Educate yourself about your condition, and get as much input and opinions as you need. 4 Find a Doctor You Like Take the time to find a urologist you feel comfortable with. “Believe it or not, you’re going to be seeing your urologist for a long time,” says Canfield, “so you should find one who feels like the right fit. You should like that person. You should trust them, and feel like they are going to help you through whatever happens.” Nothing is guaranteed, he says, “but at least you can rely on the fact that your doctor will be available and there to care for you — no matter what.” 5 Make Smart Lifestyle Moves A healthy diet, regular exercise, and weight management are important for keeping you healthy through prostate cancer treatment and preventing other diseases that can come along with getting older. Another way to look at it, says Canfield, is that diet and exercise help the immune system — and prostate cancer does seem to be somewhat affected by the immune system. A healthy lifestyle certainly can't hurt your prognosis, and it may be helpful. Here are some specific diet recommendations from the UCSF:Eat a variety of vegetables, including cooked tomatoes (which contain the antioxidant lycopene) and cruciferous vegetables like broccoli and cabbage, which some studies suggest may reduce the risk of developing aggressive prostate cancer.Avoid processed meat and poultry. Instead, choose healthier protein sources, including salmon and other fish that contain omega-3 fatty acids.Focus on good fats. Instead of fried foods and saturated fat, go for olive oil, nuts, and other vegetable fat sources.Get plenty of calcium from low-fat sources, such as skim milk, vegetables like kale and spinach, and fortified foods like whole-grain cereals and soy or nut milks. In addition to what you eat, aim for vigorous physical activity for at least 30 minutes on days when you’re feeling able, maintain a healthy weight, and don’t smoke. 6 Get Emotional Support Prostate cancer can have a big impact on many aspects of your life, including your sex life and your financial situation, and can also make you feel very alone. Remember: Asking for help is a sign of strength. You may choose to involve your spouse or partner in your care, an adult child, a sibling, or a close friend. For other sources of support, go to your doctor or nurse for ideas, search for support groups that meet online or locally, and explore resources like the Prostate Cancer Foundation. 7 Stay Positive Your final tip is to never give up. New and more precise diagnostic tools and treatments are bubbling up through the pipeline. Continue to work with your doctor to monitor your condition and determine the right treatment plan for you. Additional reporting by Andrea Peirce More in Prostate Cancer FAQs About Prostate Cancer That Has Spread to the Bones How to Involve Your Spouse or Partner in Your Advanced Prostate Cancer Care 8 Symptoms of Advanced Prostate Cancer and How to Manage ThemNEWSLETTERS Sign up for our Men' s Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. The Latest in Prostate Cancer Prostate Cancer Symptoms Diagnosis Treatment and MoreBy Laura NewmanSeptember 18, 2022 New Combos of Old Drugs Improve Survival in Patients With Prostate Cancer Day 3 of the European Society for Medical Oncology s 2021 CongressAdd-on Zytiga is expected to become the new standard of care almost immediately. 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