‘80s Heavy Metal Rock Star Eric Forrest, 55, Who’s Diagnosed With Stage 3 Prostate Cancer, Tried to Keep His Diagnosis Private, but the Cost of Treatment Has Him Speaking Out Now

Forrest learned roughly two years ago that he had stage 3 prostate cancer. Prostate cancer is categorized into four stages, with stages 1–3 generally describing disease that remains confined to or just beyond the prostate.

“The first thing is determining the stage,” explains Dr. Edward Yen, a medical oncologist at Baylor College of Medicine in Houston.

“Stages 1, 2, and 3 usually describe some form of prostate cancer that’s still localized to the prostate. Once it spreads anywhere else in the body—whether one site or 100—that’s considered stage 4,” Dr. Yen added.

Understanding the Stages of Prostate Cancer

• Stage 1: Small, confined to the prostate, often slow-growing
• Stage 2: Still confined to the prostate but larger or found in multiple areas
• Stage 3: Has grown beyond the prostate capsule, possibly into nearby tissues
• Stage 4: Has spread to lymph nodes, bones, or other organs

WATCH: PSA Test Is Not Perfect, But It Is Helpful

Forrest’s diagnosis began with routine screening, which involved a prostate-specific antigen (PSA) test. This is a blood test that can detect elevated levels of PSA, a possible indicator of prostate cancer, an enlarged prostate, or inflammation. This was followed by a digital rectal exam (DRE), a quick but vital screening tool. His PSA level was 23—well above the typical thresholds doctors use to gauge concern.

While there is no single “normal” PSA level, doctors generally consider:

• Under 4.0 ng/mL: low
• 4–10 ng/mL: borderline
• Above 10 ng/mL: more concerning for cancer

A biopsy then determines the Gleason score, a key measure of how aggressive the cancer appears under the microscope. Scores range from 6 (least aggressive) to 10 (most aggressive). Forrest says his Gleason score was 7, placing him in an intermediate-risk category.

Once the Gleason score is known, doctors assess whether the cancer has spread beyond the prostate.

“About five to seven percent of prostate cancer patients present with metastatic disease,” notes Dr. Neha Maithel, a medical oncologist at UT Cancer Center in Houston. “Prostate cancer tends to spread to lymph nodes, bones, or the lungs.”

WATCH: Why You May Have a Greater Risk When it Comes to Prostate Cancer

Forrest hasn’t shared details about whether his cancer has spread or the specific treatment he’s receiving, but he confirmed he is actively undergoing therapy.

“I have been on a daily routine to advance my situation—some days better than others,” he wrote. “Maintaining a disciplined schedule, format cycle, plus some love and support from family and close friends.”

Forrest admits that the cost of continued treatment is putting a financial strain on him and has asked fans for support through his GoFundMe.

Treating Prostate Cancer As Cases Gradually Rose In Recent Years

Prostate cancer cases have been on the rise in recent years. The medical journal of the American Cancer Society found that “the prostate cancer incidence rate has risen by 3% per year from 2014 through 2019.”

WATCH: Finding Hope During The Prostate Cancer Journey

Prostate cancer is very treatable when caught early — and thanks to incredible advances in treatment options, even prostate cancer that is caught in advanced stages can often be managed. A long-standing prostate screening tool is the protein-specific antigen (PSA) test. This test screens for prostate cancer by looking for larger amounts of protein-specific antigen in the blood. An elevated PSA test does not always mean prostate cancer, but it could indicate a man’s cancer risk is higher or lower.

“Population-based prostate cancer screening has historically relied on PSA levels, which have led to the diagnosis of many prostate cancers that are not a threat to the patient’s life,” a study published in The New England Journal of Medicine said.

In recent years, other test methods, including prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) scans and MRI imaging, have gained increasing support from cancer experts. PSMA PET-CT scans are a relatively new imaging technique that allows physicians to visualize prostate cancer cell clusters anywhere within the body. PSMA PET-CT is helpful for people with prostate cancer where there’s a high risk of the disease spreading outside the prostate gland or those who have recurrent cancers.

Magnetic resonance imaging (MRI) uses a magnetic field, radiofrequency pulses, and computer technology to generate highly accurate body images.

What Factors Go Into Treatment Choices?

For many patients, the differences between treatment options — such as surgery, radiation, or hormone therapy — can be subtle. But those nuances matter, especially when side effects impact daily life.

Dr. James Ryan Mark, a urologic oncologist at Fox Chase, urges patients to weigh the benefits and trade-offs of each treatment option carefully.

“In certain cases, the differences in treatment options can be relatively minor,” Dr. Mark explains.

WATCH: Balancing Treatment and Quality of Life: What Men Should Know About Prostate Cancer Care

One common combination for aggressive prostate cancer is radiation therapy paired with androgen deprivation therapy (ADT), also called hormone therapy, which suppresses testosterone to slow cancer growth. While this approach can significantly improve recurrence rates and survival, it’s not without cost — especially for older patients.

“Adding those treatments to radiation has a big improvement on the recurrence rate of survival,” Dr. Mark says. “But not all men sustain that big of an improvement, and particularly if you’re older, taking out your testosterone can really affect your muscle strength and vitality.”

For some, preserving strength and energy may outweigh a modest increase in cancer control.

“As patients are getting elderly, to some, that is more important than maybe a 10% [increase] in their case of prostate cancer control,” he adds.

Dr. Mark also cautions against rigid treatment protocols that don’t account for individual needs. He encourages patients to ask their care team questions and explore different types of treatments, specifically inquiring about possible treatment outcomes and the side effects they bring.

“Sometimes, it almost seems dogmatic in the way the treatments are delivered,” he says. “It’s always good to ask what the benefit of each aspect of the treatment is and what can be given in a different way.”

Dr. Vivek Narayan, a medical oncologist at the University of Pennsylvania, is part of a growing movement in oncology that embraces combination therapy as the backbone of metastatic prostate cancer treatment. This approach pairs traditional hormone therapy (also called androgen deprivation therapy or ADT) with FDA-approved oral agents like abiraterone, enzalutamide, apalutamide, and darolutamide — each designed to disrupt the testosterone-driven growth of cancer cells further.

WATCH: A Message Of Hope For Men Fighting Advanced Prostate Cancer

These therapies not only slow disease progression but also offer patients a chance at living longer, fuller lives — even with an advanced diagnosis.

Dr. Narayan highlights the progress in advanced prostate cancer care, noting that the disease is increasingly manageable and patients now have greater potential for improved quality of life. Still, patients must be carefully monitored.

“Even with metastatic prostate cancer, it’s not always the cancer that causes the biggest problems. We’ve got to keep an eye on overall health, because that matters just as much.” Dr. Narayan notes.

This shift in perspective is critical — not just for patients, but for caregivers and clinicians alike. It reframes the diagnosis from a terminal sentence to a chronic condition that can be managed with precision and care.

The outlook for prostate cancer care is promising, driven by breakthroughs in treatment and the rise of personalized medicine. Dr. Narayan’s work at Penn Medicine, among other cancer research centers across the country, continues to push the boundaries of what’s possible, offering patients not just treatment but a renewed sense of continued hope.

Prostate Cancer Screening and Warning Signs

When you do get screened for prostate cancer, your doctor will run a few tests.

One of the tests is the PSA test, a simple blood test that screens for prostate cancer. It looks for more significant amounts of protein-specific antigen (PSA) in the blood. An elevated PSA test does not always mean you have prostate cancer. It could also reflect that your prostate is enlarged, which is common, or it could signal an infection or inflammation.

Your doctor may also conduct a digital rectal exam (DRE) to check your prostate for lumps.

Depending on the results of these tests, imaging scans and a biopsy may be ordered.

WATCH: How Gleason Grade Determines Treatment

Prostate cancer does not always behave the same in every man it impacts. The cancer can be considered “low-risk” and can be slow-growing, and treatment might not be necessary. In other men, the cancer may grow faster or more aggressively, requiring more immediate treatment. Because of this, there is some debate about screening.

The United States Preventive Services Task Force recommends that men at average risk between the ages of 55 and 69 years talk with their doctor about the pros and cons of prostate cancer screening.

The American Cancer Society recommends that men at age 50 who are at average risk should begin screening. Men who are at high risk of prostate cancer should begin screening at age 40. Men with a close relative diagnosed with prostate cancer should consider annual screenings in their 30s.

SurvivorNet experts suggested that men consider factors like their family history, genes, and age when deciding whether and when to screen.

Symptoms of prostate cancer may include:

• Urinating more often
• Waking up in the middle of the night to pee
• Blood in your urine
• Trouble getting an erection
• Pain or burning when you urinate
• Pain in your back, hips, thighs, or other bones
• Unexplained weight loss
• Fatigue

If You’re Diagnosed With Prostate Cancer, What to Expect for Treatment?

After testing and establishing your risk, your doctor will discuss possible treatment options. These may range from active surveillance to more aggressive options, including surgery and radiation therapy.

WATCH: Coping emotionally after a prostate cancer diagnosis

Surgery is an option for men with any risk group of prostate cancer that hasn’t spread outside of the prostate gland. The type of surgery most often used is called a radical prostatectomy.

During the procedure, the surgeon removes the entire prostate, along with some tissue around it, including the seminal vesicles that release fluid into the semen. Your doctor can perform this through a traditional open procedure with one large or several small incisions, called laparoscopic surgery.

WATCH: Sexual Function Recovery After Prostate Cancer Surgery

Surgery side effects may include erectile dysfunction and urinary incontinence. Fortunately, the side effects are usually temporary, and there are ways to help you manage them.

“Erectile function is so sensitive when we’re dealing with prostate cancer because the nerves that are critical for this function wrap around the prostate; they’re just so intimately connected to the prostate that they can be damaged from a surgical removal of the prostate or through radiation treatment,” Dr. Isla Garraway, a staff urologist in the Veterans Administration (VA) Greater Los Angeles Healthcare System, told SurvivorNet.

Doctors often recommend sexual counseling after prostate cancer treatment to help improve sexual function. This approach actively addresses the psychological, emotional, and relationship impacts on sexual health.

Radiation therapy is often done when prostate cancer is caught early and confined to the prostate gland.

Understanding Prostate Cancer Recurrence

Prostate cancer recurrence is not all that uncommon. A study published in the medical journal JAMA followed 1,997 men who had undergone prostate removal surgery. Of those, 304 experienced a recurrence, and about 25% of those cases occurred five or more years after surgery.

Researchers believe that dormant cancer cells can hide in the body for years. The bone marrow, in particular, is considered a key hiding place. This is supported by findings published in the International Journal of Cancer, which noted, “In one autopsy study, approximately 80% of the men who had died from prostate cancer possessed bone metastases.”

Other potential reservoirs for dormant cancer cells include the lymph nodes and the prostate bed—the area where the prostate gland once was—though these are more difficult to study.

Researchers have made significant strides in understanding how prostate cancer can spread early—even when it appears to be under control—and then return months or even years later. One key discovery is that the bones are a common site for prostate cancer to spread. In fact, scientists have found dormant cancer cells hiding in the bone marrow of many patients, even when the disease seems confined to the prostate.

Lab studies, mostly using model systems, have also helped uncover how prostate cancer cells can lie dormant for long periods before becoming active again. While treatments like hormone therapy and radiation after surgery have shown promise, experts agree that more research—both in the lab and in clinical trials—is needed to improve outcomes for patients.

Questions for Your Doctor

If you have experienced symptoms associated with prostate cancer or have a screening coming up, here are some questions you may ask your doctor:

• If I had elevated PSA levels, what could be causing that besides cancer?
• How long will it take to learn if my PSA levels warrant further testing?
• What are the treatment options that are best suited for me based on my risk level?
• What financial resources exist to help me with the costs associated with treatment?
• How long will my potential treatment prevent me from working or continuing normal activities?

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