Prostate cancer can involve a choice between monitoring and active treatment, or decisions about treatment for more advanced disease. Urinary function, sexual health and the effects of hormone therapy may be important parts of that discussion. This guide helps patients in Vancouver and across Canada organize questions around both cancer control and everyday quality of life.
Making sense of PSA, biopsy and risk
A prostate-specific antigen (PSA) blood test provides useful information, but an elevated PSA does not by itself diagnose cancer. Non-cancerous conditions can also raise it. Diagnosis may involve examination, MRI and a prostate biopsy. The biopsy helps establish the cancer’s grade. Your team interprets these findings together rather than making a treatment decision from one blood result. Canadian Cancer Society: prostate cancer diagnosis.
Why immediate treatment is not always recommended
Selected lower-risk, localized cancers may be managed with active surveillance: scheduled monitoring with treatment considered if the findings change. Surgery and radiation are other options for localized disease. Hormone therapy, chemotherapy and targeted therapy may have roles in particular situations. Decisions incorporate stage, grade, PSA, health and personal preferences, including the possible effect on urinary and sexual function. Treatment overview.
Supporting function and well-being
Tell your team about urinary leakage, bowel changes, fatigue, sexual concerns or emotional strain. Supportive care can include practical management and referral for more focused help. Some hormone treatments increase the risk of bone loss, making bone health an important topic. Ask how your treatment affects exercise and nutrition planning and whether assessment for osteoporosis is appropriate. Supportive care guidance.
An integrative discussion should start with your priorities and the evidence for a proposed supportive approach. Review supplements with your oncology pharmacist before use because they can interact with treatment. BC Cancer guidance. Agree on a review date so that time, cost and symptom changes can be considered together.
Preparing for a useful discussion
Bring your PSA history, biopsy report, scan reports and treatment plan. Note changes in bladder habits, energy, mood and daily activity. It is reasonable to bring a partner or trusted person if that makes sensitive questions easier to discuss.
- What is my risk group, and what are the benefits and trade-offs of each option?
- If I choose surveillance, which tests will I need and what would trigger treatment?
- What help is available for urinary or sexual side effects?
- How should I protect bone health during hormone therapy?
Common questions
Is active surveillance the same as doing nothing?
No. It is a structured monitoring strategy for selected patients. Watchful waiting is a different approach that generally responds to symptoms rather than using the same intensive testing schedule. Ask which approach is being recommended. Care for localized prostate cancer.
Does feeling well mean follow-up can stop?
No. Follow-up remains part of prostate cancer care even when you feel well. Keep the schedule agreed with your team and discuss new symptoms or difficulty continuing a prescribed treatment. Follow-up and treatment information.
This page is educational. Individual decisions belong in a discussion with your urology and oncology teams.