This is the same story that I have been telling recently, but I believe it is important enough to repeat it again. I think we could never say it too much! The Irish Cancer Society funded a survey called PRO-ACT. 1,150 prostate cancer patients and their partners. Not just patients. Partners in the same survey, which almost never happens. 40% said they were not prepared for what treatment did to their sexual function. 60% said it was worse or much worse than they expected. The vast majority said a longer or clearer discussion with their medical team would have helped. One of the chief investigators is Martin Sweeney, who has prostate cancer himself. He was diagnosed at 49. Devastated, in his own word. He says he made a knee-jerk decision on a radical procedure, and he has lived with the effects on his sexual function, his urinary control and his mental health ever since. His relationship with his partner changed. They are still together, and he says they are better and stronger than ever. The hardest stretch was the first six months to a year. He says the outstanding reason men gave for being underprepared was that their clinician and their medical team did not give them enough information. Then Dr Claire Kilty from the Irish Cancer Society said the line I keep coming back to. When people are affected by this after treatment, there is a hesitancy to talk about it - with their partners, with their family members, and with their healthcare professionals. All three. Not one. Three. That is our whole thing, here at Prostate Paladin - sitting inside somebody else's data. I am not a doctor and I am not telling anyone what to choose. But if you are anywhere near a treatment decision, or someone you love is, the move is the same. Slow it down by a week and ask what it will do to your life, not only what it will do to the cancer. Then ask who you talk to when it does. So here is my question for the room, and I would rather have honest answers than tidy ones. Were you prepared? Did anybody actually sit you down and tell you what would change afterwards - or did you find out on your own?

Not going to the doctor is often seen as a badge of honour. Chris Kamara admits he went about twenty years without seeing a doctor and thought it made him a hero. A routine blood test eventually flagged his PSA - thankfully not cancer - and next month he runs the Great North Run at 68. Australia has just changed its rules so the doctor raises the test with men from 50, instead of sitting there waiting for the man to find the words. For me it was my friend at the airport who pointed out to me that I might have a prostate problem. Sometimes that is all it takes - one person to break the ice and bring it up. Awareness is key - which is what Prostate Paladin has been saying all along. Use the Kamara story on the men in your life this week. Ask one of them when he last had his PSA checked. It is one blood test, and it removes a mountain of worry. https://www.skool.com/prostate-paladin-4886/about

A warm welcome to Sabine and Jacob the newest members of Prostate Paladin. @sabine-leofric-5134 who designs systems that make online communities easier to run and more valuable for members. and @jacob-luke-4541 Please check out the pinned posts and the quick guides in the Classroom. Feel free to jump into the conversations and ask questions, or share what you are passionate about, and introduce yourselves. Welcome to the community.

I read a piece this week that needs to be shared. A group of doctors sat down and listed the beliefs that keep men out of the screening room. Not because the beliefs sound crazy. Because they sound reasonable. "I feel fine." "I am too young." "A high number means the worst." I want to walk through what they said, because I know a man who lived through every one of these myths and came out the other side. He is a friend of mine here in Thailand, fifty-two at the time. No symptoms. None. He caught it because his company sends everyone for a yearly physical, not because anything felt wrong. Myth one: no symptoms means nothing is wrong This is the one that gets most people. Early prostate cancer does not hurt. It does not slow your stream. It does not wake you up at night. My friend felt completely normal the whole way through. The gland does not warn you before it becomes a problem. That is exactly why the yearly test exists, not because you feel something, but because you might not. Myth two: this is an old man's disease Fifty-two is not old. The doctors in the piece said they still see men in their forties and fifties who were told they were too young to worry. My friend was squarely in that window. Myth three: a high PSA number is the diagnosis His PSA came back around four at that first physical. Four is not a death sentence. It is a number that says go look closer. They sent him for an ultrasound, then an MRI. It took nine months of watching that number climb, four up to nine, before anyone talked about treatment. A high PSA opens a conversation. It does not end one. Myth four: "incurable" is the word people reach for It is out of date. His cancer was caught early and it was slow growing, which gave him time to research his options instead of panicking into the first one offered. Two years after treatment his PSA had dropped from nine to one point seven then down to one point five. He is healthy, no lasting side effects, and he still checks it with PSA and MRI every six to twelve months.

I think this is true for any health conversation, wether it is with your mates or with your family. It is always easier to talk to a stranger. I guess that is why bartenders have to listen so well. Prostate Cancer UK ran a piece in January called "What do I tell my son?" and I have thought about the question more than the article. The short version: Nick, diagnosed at 51, caught early, on active surveillance. His doctor told him his son - 31 at the time - should start PSA tests by his early-to-mid 40s, because a father with prostate cancer means roughly two and a half times the risk. Nick called his son that night. The lad went quiet for a couple of weeks. His wife noticed before anyone else did. Two years on, it sits fine - the son knows his number and his timeline. It is much better to know that to not know. What I keep chewing on is the direction of the conversation. Almost everything I write is about getting a silent man to open up - the wife, the daughter, the mate doing the nudging. This is the other way round. The man who knows something being willing to pass it down. My brother had prostate cancer and was cured, but I did not find out until I asked him. That was years later. I have an enlarged prostate, not cancer, so I am not speaking from Nick's chair. But I have a family too, and I know the instinct to keep quiet and carry it alone. It feels like protection. It is not. For those of you who have been diagnosed - did you tell your sons and brothers? How did you say it, and how did they take it? And if you decided not to, I would honestly like to hear that side too. No judgement in this room. The prostate will affect all of us one way or another in our lifetime. Better to know early. https://www.skool.com/prostate-paladin-4886/about