Newly Diagnosed: What to Expect
You Are Not Alone
Being diagnosed with prostate cancer can feel overwhelming. Whether you discovered it through a routine PSA test, after symptoms, or during a checkup, you are now entering a new chapter—and you do not have to go through it alone. This page will help you understand your diagnosis, explore your options, and take the next steps with confidence.
Understanding Your Diagnosis
After a prostate biopsy confirms cancer, doctors look at three key factors to describe your cancer:
Gleason Grade Group– This describes how aggressive the cancer looks under a microscope. It ranges from Grade Group 1 (slow growing) to Grade Group 5 (very aggressive)
PSA Level- The prostate specific antigen (PSA) is a protein made by the prostate. Higher levels can indicate more advanced or aggressive disease
Clinical Stage- This describes how far the cancer has spread, based on a physical exam and imaging such as MRI or PET scans
Risk Categories: What They Mean
Your doctor will use your Gleason grade, PSA level, and stage to place you into one of three risk groups. These groups help guide treatment decisions and give you a better idea of your outlook.
| Risk Group | What It Means | Typical Options |
|---|---|---|
| Low Risk | Cancer is slow growing and still inside the prostate | Active surveillance or curative treatment |
| Intermediate Risk | Cancer is more likely to grow or spread | Radiation or surgery, with possible hormone therapy |
| High Risk | Cancer is likely to spread or is already spreading | Combined treatment including radiation, hormone therapy, and sometimes surgery |
Treatment Options Overview
Depending on your diagnosis, stage of disease, and personal preferences, you may have one or more of the following treatment options:
| Treatment | Best For | Key Considerations |
|---|---|---|
| Active Surveillance | Low-risk or slow-growing cancer | Involves regular PSA testing, imaging, and occasional biopsies with no immediate treatment. Aims to avoid overtreatment while monitoring for changes. |
| Surgery (Radical Prostatectomy) | Men in good health with localized cancer | Removes the prostate gland and surrounding tissue. Risks may include urinary leakage and erectile dysfunction. Robotic-assisted options are common. |
| Radiation Therapy | Localized, intermediate, or high-risk cancer | Uses external beam radiation or implanted radioactive seeds (brachytherapy). Side effects can include fatigue, bowel changes, urinary irritation, and sexual side effects. |
| Hormone Therapy (Androgen Deprivation Therapy) | Intermediate to high-risk or advanced disease | Lowers or blocks testosterone to slow cancer growth. May be combined with radiation or other therapies. Side effects include fatigue, hot flashes, and reduced libido. |
| Targeted Focal Therapy | Men with a small, localized tumor confined to one area of the prostate | Treats only the affected portion of the prostate using image guidance (MRI or ultrasound). Aims to preserve urinary and sexual function. Often used in clinical settings or specialized centers. |
| High-Intensity Focused Ultrasound (HIFU) | Localized prostate cancer, especially in men seeking a less invasive option | Uses focused ultrasound waves to heat and destroy cancer cells. FDA approved for prostate tissue ablation. Potential for fewer side effects but long-term data are still being collected. |
| Cryotherapy (Cryoablation) | Localized or recurrent cancer after radiation | Destroys prostate tissue by freezing cancer cells. Less invasive than surgery, but may cause urinary irritation or erectile dysfunction in some patients. |
| Systemic Therapies | Advanced or metastatic disease | Includes newer hormonal agents, chemotherapy, immunotherapy, and targeted radiopharmaceuticals (e.g., Pluvicto). Often combined with other treatments to extend survival and control disease. |
Click here to learn more about various treatments for prostate cancer.
Genomic and Biomarker Testing
Certain tests can help you and your care team learn more about how your cancer behaves. These tests look at genes or biomarkers in your tissue or blood. They may help predict how aggressive the cancer is or whether certain treatments may work better for you
Examples include:
Tests that predict likelihood of progression
Tests that guide decisions about surveillance versus treatment
Tests that help plan for radiation or hormone therapy
Ask your doctor whether these tests are appropriate for you
What Happens Next: A Checklist
- Review your biopsy and pathology report
- Understand your PSA level and Gleason grade
- Ask whether imaging is needed (MRI or PET scan)
- Learn your risk category (low, intermediate, or high)
- Discuss all available treatment options
- Consider a second opinion if unsure
- Talk with your doctor about side effects and quality of life
- Ask if any genomic or biomarker tests are right for you
- Explore whether clinical trials are a fit
- Make a treatment plan that fits your life and values
Patient Support and Resources
This is not a journey you need to take alone. At PCEC, we provide access to:
Free patient navigator who can answer questions and help guide your decisions
Decision tools and printable guides to support your conversations with doctors
Clinical trial listings and help understanding if you qualify
Clinical Trials
Clinical trials are research studies that test new treatments, technologies, or ways of caring for patients. Many men with prostate cancer take part in trials to gain access to promising therapies before they are widely available
You may be eligible for a trial at different stages of your diagnosis. Some trials test imaging tools or new medications. Others explore personalized treatments based on your genetic or biomarker profile
Participation is voluntary, and you can leave a trial at any time. Trials are carefully monitored to protect your safety
Search for prostate cancer clinical trials
Frequently Asked Questions
Do all prostate cancers need treatment right away?
No. Many low risk prostate cancers grow slowly and can be safely watched through active surveillance
Can I still have a good quality of life after treatment?
Yes. Many men live long and healthy lives after treatment. Side effects are common but often can be managed
Is it okay to get a second opinion?
Yes. It is always okay to talk with another doctor to make sure you understand all your options
Is surgery better than radiation?
Neither is automatically better. The best option depends on your cancer, your overall health, and your personal values. Talk with your health care team to decide which option is best for you.
What does a Gleason score of 3 plus 4 mean?
This means most of the cancer is less aggressive (grade 3) but some areas are more aggressive (grade 4). It is considered favorable intermediate risk