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 Myth four: "incurable" is the word people reach for It is out of date.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 read a letter from a wife this week. Husband, 70 years old, early prostate cancer, has not spread. He wants surgery - but not yet. He wants a year first. He is afraid of what the operation can take from him: control of his bladder, his sex life. The doctors say waiting is reasonable, with a warning attached - the window can close. She is angry, scared, and pretending to be neither. I sat with this one for a while, because nobody in that letter is wrong. The mans' concerns are valid and so are his wifes - but they are not worried about the same things. His fears are real. Those two side effects are the ones every man quietly asks about, or wants to and does not. Her fear is real too. A door that is open today is not guaranteed open next year. The part I want to put to this community is the middle path both of them may be missing. Waiting, done properly, is not nothing. It has a schedule - PSA tests, scans, appointments, a doctor watching the trend. If you take the delay, you take the job that comes with it. We have written about this before, waiting can be acceptable, even desirable, you just need to be sure to monitor closely. And the other job: saying the fears out loud, to each other, before the next appointment. The argument is never really surgery versus no surgery. It is spoken versus unspoken fears. Both valid, but widely different. Has anyone here faced this choice - or watched your partner face it? What made the decision feel right, whichever way it went?

It is an older BBC story I found this week, and I cannot stop thinking about it. Andy Probert, a heating engineer from Watford, 52, no symptoms at all - his only complaint was a bad back. He booked a routine GP visit in 2022 because Bill Turnbull, the BBC Breakfast presenter, had been open about his own prostate cancer. They found cancer. Caught early, surgery, recovered. He has an 18-month-old grandson and a granddaughter on the way. Bill Turnbull died in August 2022. Diagnosed too late. Two lines from Andy stopped me. The first: "Part of me didn't believe it because I just wasn't feeling ill." The second one is harder: "I think of Bill and part of me feels guilty." Survivor guilt from a stranger's story. Nobody warns you about that one. Sixteen years ago a man in an airport told me something I did not want to hear, and everything I do here traces back to that one conversation. So this story feels personal to me. Not about cancer, but about the fact that men just do not talk about their prostate. It takes something like this to get people to check. One man saying the words out loud is sometimes the whole difference. Has anyone here been the Andy in this story - checked because of someone else's news, a mate's diagnosis, a famous name? Or been the one who spoke up and got someone else moving? I would like to hear it. https://www.skool.com/prostate-paladin-4886/about

This is genuinely good news. Australia released new national prostate testing guidelines this week - the first real rewrite in about a decade. The big shift: GPs are now instructed to raise PSA testing with every man from 50, every two years, without waiting to be asked. Men with a brother who had prostate cancer or a father diagnosed before 65 start at 45. And if you are over 70 and healthy, the old "you can stop testing now" advice is gone - keep testing. They also built the MRI into the standard work-up before a biopsy. If you read my post last week about asking for an MRI first - that argument just became national policy in Australia the same week. That does not happen often. What strikes me most is the admission buried inside this change: the old system relied on men speaking up first, and men do not. I did not. Somebody had to tell me at an airport. Here is my question for the group: has a doctor EVER raised your prostate with you first - or have you always had to be the one to bring it up? For me I had to start adding it to my yearly physical for work. https://www.skool.com/prostate-paladin-4886/about

I read a piece in STAT News yesterday about how prostate cancer actually gets diagnosed, and it is worht repeating. Here is the short version. When your PSA comes back high - In the UK, Europe, Canada and Australia the next thing that happens is usually an MRI scan of the prostate. A picture. If the picture shows nothing, in most cases you do not get a biopsy at all. If it shows something, they aim the needles at that spot instead of taking samples across a grid of the whole gland and hoping. In the United States, that scan happened in about one case in three. That is what I want to point out to everyone. I have an enlarged prostate myself. I have not been down the biopsy road, so I am not speaking to you from that chair. But I do know what it is to find out years later that there was something I could have asked about and nobody told me. That is most of the reason this place exists. I do know my friend who did have prostate cancer; he had the MRI first and then the biopsy. They were able to target the area where the cancer was with ~50% of the biopsy needles. The remaining 50% they did random samples across the prostate. Three things I want to be straight about. A biopsy is the only way to be sure if it is cancer or not. An MRI cannot confirm cancer. The doctors are genuinely split. There is good data saying the grid biopsy still turns up about 8 percent more cancer that needs treating, even after the targeted one has been done. Nobody in that article was a fool, so there are good reasons for doing it both ways. And this is not me saying skip the test or skip the biopsy. I am not a doctor. It is me saying a man should know there is a fork in the road before somebody else picks a direction for him. So - has anyone here been offered an MRI before a biopsy, or asked for one? I want to know what your doctor said, and whether it changed anything. https://www.skool.com/prostate-paladin-4886/about