Gay and bisexual men make up 5-10% of the US male population. Little data exists on the prevalence of prostate cancer in gay and bisexual men but there is no evidence that there is a lower incidence of prostate cancer in this group. We report data from an Internet-based survey of gay men in the US and Canada, including disease-specific quality of life, psychological burden of disease, and treatment satisfaction. We also discuss five years of experience in facilitating support groups for gay and bisexual men living with prostate cancer, with suggestions for how to serve the unique needs of this population.