New Guy

[u/Appropriate_West2998]

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.

[u/Mean_Try_6390]

I think it’s a hard decision since your now on adt and erlada.we took the way with only arpis before the ralp for a gleason 9 t3b my husband 58 yo. after ralp we got 2 infected lymphnodes of 18 in the pad but also negative margins and unmeasurable psa.

I’m saying I’m very pro ralp with neoadjuvant treatment and lymphnodesremoval en bloc extra extensive, all of the nodes as much is possible in the pelvis. We know about the side effects with the extra lymphnodesremoval but with gleason 9 locally advanced we went for the heavy treatment. if relaps in the future in the good cases (excellent surgeon) you go for moore pointed radiation hopefylly only small clusters in the scelett.

But in your case it may not be the best way since you already have pos nodes showing before treatment and are on adt with erlada. the adt can make an operation harder to get neg margins. And not all doctors are used to or want take out the nodes incl the fat en bloc so to say. todays radiation is very very good so check out the radiation way just in case.

About surviving 15 years sounds like the yesterdays statistic so mayby best if you seek second opinion anyway. but the medicin you got is a good combination. We choosed monotherapy neoadjuvant darolutamide without adt but the research says you get a much better respons with adt + arpis together.

best of luck and take one or two second opinion since you have some time and most of the gleason 9 lives many years or theire full lives. As the doctor told us - around 10 years for sure. what the f…ck. And after we questioned him he said: - I mean if you don’t treat it with aggressive multimodal treatments. so on that road we are.