Questions to Ask Your Doctor After a Prostate Cancer Diagnosis

TL;DR

• You are allowed to ask for a second opinion, especially before making a major treatment decision.
• Ask what your stage, Gleason/Grade Group, PSA and risk group mean together, rather than focusing on one number.
• Ask about all reasonable treatment options and why one is being recommended over the others.
• Discuss realistic effects on urinary function, sexual function, energy, bones, heart health and everyday life before treatment begins.
• For metastatic prostate cancer, ask whether molecular testing, PSMA imaging, combination treatments or clinical trials are relevant to your situation.

Should you get a second opinion?

A second opinion doesn't mean you distrust your doctor — it means understanding whether other reasonable approaches exist before a major decision.

One of the strongest themes in patient experiences shared with mama health is simple: "I wish I had asked someone else too." \[4\] Some men accept the first proposed treatment and only later learn a multidisciplinary team might have discussed different options.

• Would it be reasonable for me to get a second opinion before deciding?
• Could my case be reviewed by a multidisciplinary team (surgery, radiotherapy, medical oncology)?

What should you ask about your stage and risk group?

Ask how your PSA, Gleason score/Grade Group, and stage connect — not what each number means in isolation.

• What exactly is my stage, Grade Group, and risk group — and can you write it down?
• Is the cancer localized, locally advanced, or metastatic?
• What does this combination mean for how the cancer may behave, my treatment options, and my outlook?

What should you ask about treatment options?

Ask what's reasonable for your specific cancer, and why one option is being recommended over the rest.

• What are all the reasonable treatment options for my stage and risk, and why this one?
• Am I suitable for active surveillance? If not, why?
• Do I need to decide immediately, or is there time to consider?

If surgery is on the table, also ask: how often does this surgeon/center perform this procedure, what urinary and sexual-function outcomes are typical, and am I a candidate for nerve-sparing surgery? If radiotherapy is on the table, ask which type, how many sessions, whether hormone therapy is also needed, and what bowel, bladder or sexual side effects to expect.

What should you ask before starting hormone therapy?

Hormone therapy affects more than the cancer — ask about the everyday impact too.

• How long might I need it, and what side effects are most relevant for me (energy, weight, mood, sexual function)?
• Do I need bone-health assessment, or monitoring of blood pressure, glucose or cholesterol?

Should you ask about additional testing?

PSMA PET imaging and BRCA/genetic testing aren't needed by everyone — but it's worth asking whether they're relevant to you.

Current EAU guidance recommends BRCA assessment in metastatic prostate cancer because it can affect treatment selection; AIOM publishes specific guidance on implementing this in Italy. PSMA PET is used in several specific staging and recurrence situations.

• Would PSMA PET or genetic/BRCA testing change how you'd treat my cancer?
• If not recommended, why wouldn't it add useful information in my case?
• Could a genetic result have implications for my relatives?

What should you ask if the cancer is metastatic?

Ask what type of metastatic disease you have and what treatment combinations are relevant now.

• Is my cancer hormone-sensitive or castration-resistant? How much disease is present, and where?
• Why this combination of treatments — is intensification (triplet therapy) appropriate for me?
• Are molecular tests or clinical trials relevant now?

What should you ask about side effects and prognosis?

Ask about realistic side effects before treatment begins, and what your outlook means in practical terms.

Patient conversations shared with mama health repeatedly describe feeling unprepared for the everyday reality of treatment. \[4\]

• What side effects are most likely, which usually improve versus persist, and what does recovery look like at 3, 6 and 12 months?
• What factors make my outlook more or less favorable, and what would progression look like?

What should you ask before leaving the appointment?

You should leave knowing who to contact, what happens next, and when you'll be reviewed.

• Who is my main point of contact, and when is my next PSA test or scan?
• Which symptoms should I report before then?
• Is psychological support, continence/sexual-health support, or a dietitian available?
• Are patient groups or clinical trials relevant to me?

The 10 questions to bring if your appointment is short

1. What exactly is my stage, Grade Group and risk group?
2. What do those results mean for my outlook?
3. What are all the reasonable treatment options for me?
4. Why are you recommending this treatment over the alternatives?
5. Would a second opinion be reasonable before I decide?
6. What are the realistic long-term effects on urinary and sexual function?
7. How could treatment affect energy, mood, bones, heart health and daily life?
8. Do I need PSMA imaging or genetic/molecular testing?
9. How will you know whether the cancer is responding or progressing?
10. Who do I contact with questions or side effects between appointments?

Bring the list on paper or your phone. You don't need to ask everything in one visit — you are allowed to ask hard questions before making a major treatment decision.

Disclaimer: This content is informational. mama health offers information and support and does not replace a doctor.