Most people with advanced prostate cancer are treated with androgen deprivation therapy, or ADT. These are medicines that stop the body from making testosterone or block it from fueling cancer cells. Your doctor may also suggest a round of chemotherapy up-front.

There's some evidence that people with advanced prostate cancer who add a second type of hormone therapy (a second generation anti-androgen) live longer than people who only get treatment with standard ADT. If your doctor only prescribes one type of drug, ask them why.

Everyone with metastatic prostate cancer should be offered germline testing. These are tests that look for inherited cancer-causing genes. Your results not only affect your treatment options, but they can tell you if your family members should be screened for genetic mutations that raise their risk of cancer.

Your doctor will give you regular PSA tests. Every few months or so, they'll look for certain benchmarks that show a reduction in your PSA level. This tells them if you're responding to treatment. You may also get bloodwork, imaging tests, or biopsies to see if your cancer has spread.

I was open to whatever would give me the best chance of getting rid of my cancer. I was less concerned about preventing side effects like impotence or urinary problems. My personal preference for treatment helped my doctor create the best plan for me. 

 Having the best quality of life? Having fewer side effects from treatment? Living as long as possible no matter what? 

This could be anything from urinary incontinence and erectile dysfunction to hot flashes and mood swings. If you're not sure what to expect, ask for a list of side effects you should prepare for. 

Your doctor wants to make sure you're staying on top of your other medical conditions, including things like high blood pressure, diabetes, kidney disease, or high cholesterol. Mention any new issues that come up after your diagnosis, including anything involving your mental health. 

Palliative care specialists can help you with things like pain, weight loss, sexual function, mental health issues, urinary dysfunction, or other symptoms and side effects from cancer or treatment. This kind of supportive treatment is useful at the beginning and throughout the whole course of your disease process.