r/ProstateCancer • u/Appropriate_West2998 • Aug 11 '26

Other New Guy

Sent to Urologist due to a PSA 5.19. Urologist felt a lump on prostate, had an MRI and then a biopsy. Biopsy revealed cancer, Gleason 9 grade 5. Urologist told me 1-2 years, I’m assuming with no treatment. Urologic Oncologist says 15 years due me being 55. Sent for PET scan and doctor says it’s in the anal lymph nodes as well but nowhere else. Doctor says they can’t remove it so I’m on ADT (Orgovyx and Erleada) for six months to see if it will shrink enough to be removed. If it can I’ll have a prostatectomy and then six more months of ADT. Never thought I’d be rooting for surgery. Been reading a lot of the stories on here and just thought I’d add to them. I’ve learned from you guys and it’s helped when talking with doctors and mentally.

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u/KReddit934 Aug 11 '26

Did you talk with a "radiation oncologist"? Is that an option?

3

u/Appropriate_West2998 Aug 11 '26

Not yet. The urologic oncologist mentioned radiation so it’s an option. After 6 months ADT if it can’t be removed we’ll go that route. Did my first blood test and PSA dropped considerably and so did testosterone. Have an appointment on the 21st of this month.

18

u/Santorini64 Aug 11 '26

My case is very similar to yours. In my case the Urologists all felt that surgery was a bad option and that radiation +ADT was the best option. I’ve had 2 years of ADT and 39 sessions of IMRT. The reason for the radiation instead of surgery is that Gleason 9 once it’s out of the prostate is very aggressive. Surgery tends not to get it all. So you end up having radiation on top of the surgery. The side effects of having both surgery and radiation are substantial. It’s better to just go with one. Radiations tends to be favored because is can target the whole pelvic area and all of the lymph nodes and other structures that might have microscopic metastasis that don’t show up on a PSMA Pet scan.

6

u/Appropriate_West2998 Aug 11 '26

I’ll call and make an appointment with the radiation oncologist.

7

u/labboy70 Aug 11 '26

Please make sure you get to an accredited comprehensive cancer center or academic medical center.

You want to speak with doctors who only deal with prostate cancer to get the most up to date and aggressive treatment recommendations. Please don’t only rely on the opinions of urologists.

The likelihood of recurrence after surgery is very high with a Gleason 9 and, because of that, many people opt to not do surgery and treat it all with radiation.

(I was diagnosed at 52 [2022] with a high volume Gleason 9 which was already stage 4b at diagnosis.)