Please help ,gleason score 9 - Advanced Prostate...

Advanced Prostate Cancer

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Please help ,gleason score 9

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My dad was diagnosed with prostate cancer back in june 2015 psa 62 bone scan negetive gleson 3+4..he went robotic prostatectomy in aug 15 and gleson score elevated to 4+5 with right seminal vesicle showing bit of cancer.Psa after 3 months came down to undetectable but soon after another 3 months it went to 0.2 and started increasing.Our urologist then suggested ADT for next 6 months and psa came down to 0.1 then he went to 44 rounds of imrt psa after 3 months of imrt to pelvic area was .1 and after 6 months it was.16.Then the oncologist suggested adt again.We were not expecting adt though.After 9 months of imrt with 1 adt psa came as 0.02.Then we wanted to do a bone scan but instead they did a bone density test and that also came fine.Then oncologist suggested a break for adt(zoladex) and now after 3 months without adt psa elevated to 0.10 from <0.02.The only fear is if we start adt again then he'd become castrate resistant and in India oncologist generally don't follow xtandi zytiya or docatoxyl before castrate resistance..What can we expect?

BTW he is fit and fine

Thanks in advance

3 Replies

Everyone is different, what to expect, only God knows.


Hi. I'm not an expert at PC yet but I'm learning. My numbers are Gleason 9 4/5 when I was diagnosed 2 years ago. I was placed on Lupron last November. The cancer was wrapped around the seminal vesicle so I had a non-nerve sparing Irobotic prostate removal that went fine. They did not find any cancer in the lymph nodes but the could not get good margins on one side so I still have a tumor on the bladder. After treatment I was given a holiday from Lupron to see if my PSA and testosterone numbers went up. They did start rising, but it felt wonderful to be off Lupron even for just 3 months. I am about to start radiation. The best I can say for your dad is that once you have it, and it is outside the prostate, it seems most folks agree that he's probably going to fight prostate cancer for the rest of his life. Then it becomes a game of attrition. Some of the more savvy guys will be along to comment soon I hope. Just know that you are not alone and that your dad likely has many years ahead of him. I am also curious as to how long I have. The answer seems to be "nobody knows" but my best guess is 10 years given the current state of medicine in the US.

Detection of castration-resistance may occur a few months later with intermittent ADT (castration resistance cannot be detected while on vacation), but the survival time is the same. The decision should be made on the basis of QOL.

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