Dealing with a diagnosis

It is normal to feel shocked

Hearing the words "you have prostate cancer" is a big moment. Most men feel shocked, even when they were already worried something might be wrong. Partners, children, and other family members are often shaken too.

You do not need to make any decisions in that first appointment. Take the time you need to ask questions, talk to people who matter to you, and get a clear picture before choosing what happens next.

What a careful first consultation looks like

In Dr Kooner's practice, the first proper conversation about a new prostate cancer diagnosis usually takes around an hour, on one or two visits. Family members are very welcome to come along, and most men find that helps. The conversation typically covers three things:

1. The pathology. Going through the biopsy report, the Gleason score, and the stage of the cancer in plain language.
2. The likely natural history. What is realistically likely to happen with no treatment, and with treatment.
3. The treatment options, with the pros and cons of each.

The treatment options that are usually discussed

• Active surveillance with planned monitoring and a clear plan to step in if needed.
• Surgery - open, laparoscopic, or robot-assisted.
• Radiotherapy - external beam, high dose rate brachytherapy, or low dose rate (seed) brachytherapy.
• Focal and emerging treatments such as cryotherapy and high-intensity focused ultrasound (HIFU), in selected cases.
• Hormone therapy, usually for older men or where there is evidence of spread.

Dr Kooner offers all of these treatments in his own practice, which makes it easier to compare them honestly without bias towards any single option.

How the decision is made

The right treatment depends on:

• The grade and stage of the cancer.
• The size of the prostate and any previous surgery.
• Your age and your other health issues.
• Your own preferences - particularly how you weigh up the different possible side effects.

Different men make different choices, and that is appropriate. Some want the cancer physically removed and choose surgery. Others would prefer to avoid an operation and choose radiotherapy. Some prefer to start with active surveillance. There is rarely a single "right" answer.

Practical things that help

• Bring someone with you. A second pair of ears almost always picks up something you missed.
• Write your questions down before the appointment.
• Take notes, or ask if you can record the conversation on your phone for later.
• Ask for written or trusted online information to read at home (the detailed and short-version pages on this site are designed for that).
• Take time to talk to people you trust - your partner, family, GP - before deciding.