After receiving a diagnosis of stage 3 or 4 prostate cancer, you’ll likely have many questions. Over the next few months, you’ll work alongside a team of doctors to complete your treatment regimen as you make your way toward recovery.

A diagnosis of prostate cancer can be overwhelming and confusing. This doctor discussion guide gives you some ideas on what to ask your doctor, so you’re well-versed about your cancer and your treatment plan.

What are my chances for recovery/remission?

To fully understand the answer to this question, you’ll need to know the exact clinical stage and Gleason score (grade) of your prostate cancer and whether or not your cancer is considered aggressive. If your doctor hasn’t reviewed this with you yet, make sure he or she does right away.

There are many factors that inform a person’s chances for recovery, including age and overall health. Every case is unique.

Your doctor will likely mention the 5-year survival rate for your grade of prostate cancer. Survival rates tell you what percentage of people with the same stage cancer are still alive five years from their diagnosis.

For stage 3 and 4 prostate cancer, the 5-year survival rates are:

  • Stage 3A (local stage): nearly 100 percent
  • Stage 3B and 4A (regional stage): nearly 100 percent
  • Stage 4B (distant stage): 29 percent

Keep in mind that survival rates are meant to be a guide. They can’t predict what will happen for your case specifically. They can only help give you an idea of how likely it is that your treatment will work.

How much has my cancer spread?

Advanced prostate cancer means that the cancer has spread (metastasized) to other parts of the body.

It’s important to understand whether your cancer has spread to local tissues or if it has spread to distant parts of the body. Cancer that has metastasized to distant parts of the body is harder to treat.

When does treatment start, and how long does it last?

If your cancer is still in the local stage or is non-aggressive, your doctor may recommend watchful waiting before you begin treatment. This is also called active surveillance, which means your doctor will monitor the cancer very closely. But if your cancer has already reached stage 3 or 4, your doctor will likely want to begin treatment right away.

Your exact treatment plan depends on your particular case of cancer. Some of the options for treating more aggressive kinds of prostate cancer include:

  • surgery to remove the prostate gland (prostatectomy)
  • surgery to remove the testicles (orchiectomy)
  • immunotherapy
  • hormone therapy (androgen deprivation therapy)
  • radiation
  • chemotherapy
  • cryosurgery/cryoablation
  • treatment for bone metastases if the cancer has spread to your bones

Most men will require a combination of treatments. Ask your doctor for an estimate of how long you should expect to receive each type of treatment. The length of time you’ll be receiving treatment also depends on how well you respond to each therapy. Your treatment may need to be adjusted over time.

What side effects should I expect from treatment?

There are many known side effects to prostate cancer treatments. They will depend on the exact treatment and dosage you’re receiving.

A lot of men are worried about having problems with incontinence or impotence following treatment. If you have surgery to remove your prostate gland, you’ll no longer ejaculate semen and can’t naturally father a child, but you should still be able to have an orgasm.

Some men will have problems achieving or maintaining an erection after treatment. Your doctor can help you understand what medications or tools are available to help with these complications if you experience them.

Also, be sure to ask your doctor if there are any important side effects that you should tell them about right away, like signs of a serious infection. Though rare, certain side effects of chemotherapy or radiation can be dangerous. Your doctor may need to prescribe additional medications to manage these side effects.

Are there any support groups available nearby or online?

Your doctor can direct you to local support groups, online forums, and popular blogs so you can connect with other people who have cancer or are in recovery. Your family and friends may not fully understand what you’re going through, so it’s important to connect with others who can relate.

The American Cancer Society has many great programs and services to help people with cancer throughout treatment and recovery. Their programs are completely free.

Your emotional well-being should not be put aside as you deal with the physical symptoms of treating cancer. If you’re feeling particularly stressed, depressed, or anxious, have your doctor refer you to a psychologist or other mental health professional. There are also some social workers who specialize in working with people with cancer.

How am I going to pay for treatment?

Financial concerns are often one of the biggest sources of anxiety in people diagnosed with cancer. Your doctor can direct you to someone, like a social worker, who can help organize your finances. If you have insurance, the insurance company may be able to help you navigate costs.

Once your doctor decides on a treatment, the pharmaceutical company that manufactures the drug may also offer financial savings programs to help you if your insurance won’t cover enough of the expenses.

Patient advocacy groups and non-profit organizations are also a great resource for financial support. Ask your healthcare team if they have any recommendations for you.

What lifestyle or dietary changes should I make during and after treatment?

Cancer and cancer treatment can affect your appetite and make you feel incredibly fatigued. A healthy diet plan won’t cure prostate cancer, but it can go a long way in keeping your energy levels up. In the past, exercise wasn’t recommended during cancer treatment, but that’s changed. Your doctor can give you a better idea of what is considered a safe amount of exercise to engage in during your treatment, along with tips for reducing fatigue.

If you’re not sure what foods you should be eating or if you’re having trouble maintaining a healthy weight, ask your doctor for a referral to a licensed dietitian. Most will recommend that you limit red and processed meats, sugar, and salty foods, and consume more fruits, vegetables, and whole grains.

Where can I find more educational resources about my cancer?

Your doctor can provide you with informational pamphlets and useful websites to help you learn more about your cancer.

You can also contact the National Cancer Information Center by phone or live chat if you have any questions. The phone line is available 24 hours a day, every day.

The bottom line

Every case of cancer is different. Your doctor will be your most important resource during and after your treatment for prostate cancer. Nurses and social workers that work alongside your doctor can also answer some of your questions.

Coming prepared to discuss your concerns will ensure you leave your doctor’s office feeling more in control of your diagnosis and treatment.