This week, the Cochrane Collaboration — the organisation that produces the most rigorous health evidence reviews in the world — published an updated analysis of PSA screening. Six trials. 800,000 men. Their conclusion: PSA screening reduces prostate cancer deaths with "moderate certainty." This is significant because it was the 2013 Cochrane review that helped push PSA screening out of favour in the first place. Doctors became cautious. Men used it as a reason to wait. Guidelines pulled back. The 2026 update has reversed that. Two fewer deaths per 1,000 screened. Overdiagnosis is still a real consideration — more cancers get detected, some of which might not have caused harm. That nuance matters and it belongs in every doctor conversation. But the headline is clear: the test works. For the families in this community — if the man in your life has been using "the science is uncertain" as his reason not to get tested, that argument just ran out. My friend's increasing PSA levels helped him to detect cancer when it was still localised to the apex of his prostate. He had HIFU (High Intensity Focused Ultrasound) surgery and is still cancer free 5 years later. So early detection does work. Has anyone here used this kind of research to start a conversation with someone who was resistant to getting a PSA test? What finally got through to them?

This connects directly to something I've talked about in the books and on YouTube: the single PSA reading isn't the whole picture. My friend had a PSA that went from 4 to 9 in 9 months. The trend was worrying. A biopsy confirmed cancer, and he was successfully treated. Ber sure to keep track of your PSA values. A new algorithm developed at the University of South Carolina — now being licensed for commercial development — formalizes something that experienced urologists have known for a while: the rate of rise in PSA over time (PSA velocity) is often more informative than the number itself. The algorithm analyzes the shape of your PSA curve across multiple measurements. Aggressive prostate cancers tend to accelerate — the slope gets steeper. Benign causes like BPH or inflammation tend to produce a slower, flatter rise. Two men with the same current PSA level may have completely different clinical pictures once you look at how they got there. It's not widely available yet as a standalone clinical tool — it's being commercialized now. But the principle is immediately actionable: at your next appointment, ask to see the PSA history, not just the current result. Most clinics have it on file. It just doesn't always make it into the conversation. Has anyone here been tracking their PSA numbers over time? How long a history do you have, and has any doctor ever walked you through the trend rather than just the latest reading?

This one is specifically for community members who are in the active surveillance phase, or who have a family member in it. New research published this week in the Journal of Urology evaluated a urine-based test called MPS2-AS in more than 300 men with low-grade prostate cancer being monitored on active surveillance. The results: — 97% sensitivity for detecting high-grade cancer (Grade Group ≥3) — 99% negative predictive value for cancer upgrading — Would have avoided 64% of unnecessary biopsies while still catching every cancer that needed treatment For men who've been through the repeat biopsy cycle — you know what that routine costs. Not just physically. The weeks of waiting before and after. The mental load of not knowing. The effect on the people around you. This test doesn't replace the monitoring conversation with your urologist. But it gives that conversation a new tool — one that might mean the biopsy only happens when there's a real reason. Currently the study only covers 300 men, but the results are very encouraging. Watch this space. Is anyone here in the active surveillance phase? Or supporting someone who is? I'd love to hear what the monitoring cycle has actually been like — the research is important, but your experience matters more to this community.

Sharing this one because it's exactly the kind of "knowledge is armor" story that matters most to this community. Yale researchers published findings this week on PSMA-PET imaging — a newer technology for detecting prostate cancer spread. Compared to traditional bone scans, PSMA-PET detects spread earlier and with greater sensitivity. Men who received this imaging were more likely to start the right treatment sooner. It's not experimental. It's available at major cancer centres now. The issue is that most men and families don't know to ask for it specifically. The pattern I keep coming back to: the advances happen, the evidence accumulates, and then they sit behind clinical inertia while men receive the older, less sensitive approach — not because PSMA-PET isn't available, but because nobody told them it was an option. The question to ask if you or someone you love is at the staging or restaging point: "Is PSMA-PET imaging available here, and is it appropriate for my situation?" Has anyone in the community had experience with PSMA-PET imaging? Did it change your treatment decisions?

Something from this week's news cycle that I think is worth talking about here. Health experts published concerns this week about the number of men showing up to clinics with advanced BPH that has been silently worsening for years. The common thread: men assumed the symptoms were just ageing, so they never mentioned them. This isn't a single country's story. It's a universal one. The progression of BPH is quiet and gradual. The night trips, the weak stream, the urgency — they feel like background noise. So men file it under "normal" and keep going. By the time they mention it, the options have narrowed. What this community exists to do — and what both my books are built around — is change that default. From "I'll deal with it" to "I'll mention it." From silent worsening to informed conversation. Has anyone here had the experience of mentioning a symptom earlier than you expected and being glad you did? What made you finally say something?