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Living with cancer· Appointment prep

Appointment sheet: Prostate cancer

One page to bring and write on: your details, the questions for Prostate cancer plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Prostate cancer

Prepared with OnCo (onco.cc/prep/prostate/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

38 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example PSA, Gleason / Grade Group, PSMA PET, HRR genes, PTEN), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Localised
  1. 5.For my situation (localised), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for ArteraAI Prostate, and what side effects should I expect?
Metastatic hormone-sensitive
  1. 7.For my situation (metastatic hormone-sensitive), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Capivasertib, and what side effects should I expect?
Castration-resistant
  1. 9.For my situation (castration-resistant), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Lutetium-177 vipivotide tetraxetan, Olaparib, Niraparib or related drugs, and what side effects should I expect?
  3. 11.How do the results of VISION and PSMAfore apply to someone like me?
Screening
  1. 12.For my situation (screening), which of the standard options do you recommend and why?
  2. 13.How do the results of PRECISION apply to someone like me?
Localised, low / favourable-intermediate risk
  1. 14.For my situation (localised, low / favourable-intermediate risk), which of the standard options do you recommend and why?
  2. 15.Am I a candidate for Decipher Prostate, ArteraAI Prostate, and what side effects should I expect?
  3. 16.How do the results of ProtecT apply to someone like me?
Localised, unfavourable-intermediate / high risk
  1. 17.For my situation (localised, unfavourable-intermediate / high risk), which of the standard options do you recommend and why?
  2. 18.Am I a candidate for ArteraAI Prostate, and what side effects should I expect?
  3. 19.How do the results of STAMPEDE apply to someone like me?
Biochemical recurrence
  1. 20.For my situation (biochemical recurrence), which of the standard options do you recommend and why?
  2. 21.Am I a candidate for Enzalutamide, and what side effects should I expect?
  3. 22.How do the results of EMBARK apply to someone like me?
Metastatic hormone-sensitive (mAPMN/S)
  1. 23.For my situation (metastatic hormone-sensitive (mapmn/s)), which of the standard options do you recommend and why?
  2. 24.Am I a candidate for Abiraterone acetate, Enzalutamide, Apalutamide or related drugs, and what side effects should I expect?
  3. 25.How do the results of ARASENS and PEACE-1 apply to someone like me?
Non-metastatic CRPC
  1. 26.For my situation (non-metastatic crpc), which of the standard options do you recommend and why?
  2. 27.Am I a candidate for Apalutamide, Enzalutamide, Darolutamide, and what side effects should I expect?
Metastatic CRPC, first line
  1. 28.For my situation (metastatic crpc, first line), which of the standard options do you recommend and why?
  2. 29.Am I a candidate for Olaparib, Talazoparib, Niraparib or related drugs, and what side effects should I expect?
  3. 30.How do the results of PROpel and TALAPRO-2 apply to someone like me?
Metastatic CRPC, later lines
  1. 31.For my situation (metastatic crpc, later lines), which of the standard options do you recommend and why?
  2. 32.Am I a candidate for Lutetium-177 vipivotide tetraxetan, Cabazitaxel, Radium-223 dichloride or related drugs, and what side effects should I expect?
  3. 33.How do the results of VISION and ALSYMPCA apply to someone like me?
Any stage
  1. 34.Are there clinical trials I could join, for example of Actinium-225 PSMA agents, Ifinatamab deruxtecan, Capivasertib, Tarlatamab?
  2. 35.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 36.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 37.I read that “Overdiagnosis vs. underdiagnosis in screening”. How does that affect my plan?
  5. 38.I read that “Neuroendocrine transformation”. How does that affect my plan?

The words I may hear

  • Crossover in trials: When patients in a trial's control arm are allowed to switch to the experimental drug after their cancer progresses.
  • Androgen receptor pathway inhibitor (ARPI): The newer prostate cancer hormone pills (abiraterone, enzalutamide, apalutamide, darolutamide) that block the androgen receptor or the last steps of androgen production, used on top of standard testosterone suppression.
  • Radical prostatectomy: Removing the entire prostate gland and seminal vesicles for localised prostate cancer, now almost always with a robot.
  • PSA50 / PSA90 response: PSA50 is the share of patients whose PSA falls by at least half on treatment, and PSA90 the share whose PSA falls by 90%.
  • Orchiectomy: Surgical removal of a testicle: the diagnostic and first curative step for testicular cancer, or of both, as a cheap permanent form of hormone therapy in prostate cancer.
  • Hormone therapy: Treatment that starves cancers which grow in response to a hormone, mainly oestrogen in breast cancer and testosterone in prostate cancer, by lowering the hormone or blocking its receptor.
  • mCRPC and mHSPC (castration-resistant vs hormone-sensitive prostate cancer): Prostate cancer starts out fed by testosterone (hormone-sensitive) and shrinks when it is removed.
  • Androgen deprivation therapy (ADT): Switching off testosterone, the hormone that feeds prostate cancer, with injections (or tablets) that stop the testicles making it, or by removing them.
  • Biochemical recurrence (BCR): PSA rising again after surgery or radiation, usually years before anything shows on a scan.
  • AR-V7 splice variant: A truncated form of the androgen receptor that is permanently switched on and ignores hormone-blocking pills.

Tests and results to bring

Biomarker results to ask for: PSA, Gleason / Grade Group, PSMA PET, HRR genes (BRCA2, ATM, etc.), PTEN, MSI, AR-V7 (research), Decipher / ArteraAI, PSA, PSA density, PSA doubling time, Grade Group (Gleason) and cribriform/intraductal pattern, mpMRI PI-RADS score, PSMA PET (SUVmax, total tumour volume) for staging and radioligand eligibility, Germline and somatic HRR genes (BRCA2, BRCA1, ATM, PALB2, CDK12), PTEN loss (IHC or NGS) for capivasertib, MSI/dMMR (~3%, pembrolizumab), Decipher genomic classifier; ArteraAI digital pathology, AR-V7 (CTC) in research/limited use, Testosterone level (castration confirmation), Neuroendocrine markers (chromogranin, synaptophysin, RB1/TP53 loss) on progression.

Scans and tests linked to this cancer: Active surveillance, Companion diagnostics, Germline (hereditary) testing, HRD & BRCA testing, HRD genomic scar scores (GIS, LOH, HRDetect), In-room imaging for radiotherapy (cone-beam CT, ExacTrac, CT-on-rails, HyperSight).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call