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Prostate Cancer Monitoring Chart

Track Your Progress and Treatment Journey

Oncology

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Template Content

Last updated: Mar 24, 2025

Personal Information

  • Name: _________________
  • Date of Diagnosis: _________________
  • Medical Record Number: _________________

PSA Tracking

Date PSA Level (ng/mL) Notes

Treatment History

Hormone Therapy

  • Start Date: _________________
  • Type: _________________
  • Frequency: _________________
  • Side Effects: _________________

Radiation Therapy

  • Start Date: _________________
  • End Date: _________________
  • Total Sessions: _________________
  • Location Treated: _________________

Symptom Monitoring

Rate symptoms from 0 (none) to 10 (severe)

Date Fatigue Pain Urinary Issues Other

Medication Log

Medication Dosage Frequency Start Date End Date

Important Contacts

  • Oncologist: _________________
  • Nurse Navigator: _________________
  • Emergency Contact: _________________

Notes and Questions for Next Visit

Upcoming Appointments

  • Next PSA Test: _________________
  • Next Oncology Visit: _________________
  • Next Imaging: _________________

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