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Dad just diagnosed with Gleason 9

Hi there,

I am a very worried daughter with a father that has just been diagnosed with Gleason 9 Prostate Cancer.

I am wondering if anyone can shed any light on the below information, please excuse my ignorance. I have been trawling the internet for days and haven't been able to really eat or sleep with worry.

My dad is 73 years of age. Over the last few weeks we have gone from a raised PSA level 8.7 (up from 6 in 2022 and 2021, 5.1 in 2020), Negative DRE, to an MRI (PIRADS 5, SAG T2) to a positive biopsy (10 cores taken, 9 positive, overall score G9) and now we are scheduled for a PSMA PET Scan on Wednesday.

I understand that G9 is a very aggressive cancer and I am petrified of loosing my dad. I am sick with worry that we will find that the cancer has already spread after the PSMA PET scan and I am preparing myself to support my father through what comes next.

Can anyone shed any light on what the above could mean, what treatment options may be available to him? Is G9 curable or are we just looking at managing cancer long term.

Thank you and I apologise in advance if anything is unclear or has already been addressed in other threads.

  1. Hang in there! I applaud your searching for information, as being well informed is definitely helpful in navigating the process of prostate cancer management. As you are probably well aware, just pick reputable sites like Mayo Clinic, Cleveland Clinic, etc. to get the most reliable and up to date info. While prostate cancer is generally not considered curable, with various treatments many of us do experience remission, sometimes for extended periods of time.

    For what it is worth, I was diagnosed with Gleason 9 in October 2012 and I'm still here nearly 12 years later. In my case, the diagnosis came after a 5th biopsy over about a dozen years of watching PSA increase. I had a robotic prostatectomy December 2012 and about 8 months later had 37 sessions of radiation because the PSA showed some cancer remained after surgery. Back then I was fortunate to have an oncologist who also had a PhD and was deeply involved in research, so he had me get an Eligard shot (hormone therapy) a month before starting radiation because the research indicated doing both simultaneously was better than radiation followed by hormone therapy. It worked well for me.

    There are several different approaches for treatment. I personally think it is best to have both my urologist and oncologist working together to decide on the best approach.

    Best wishes to you and your dad.

    1. Hi . First, let me say that your concerns are certainly understandable and it is fantastic that your father has you advocating and researching on his behalf. Just to follow up on the excellent information from , we have a number of contributors here and community members who have been diagnosed with Gleason 9 or even 10 who have undergone treatment and are doing well.

      It sounds like you are taking the right steps and it is great that he is getting a PSMA which is the gold standard for detecting whether there has been any spread/metastasis (see: This test will tell you a lot about what options are then available for next steps. Often the prostatectomy is taken off the table if the cancer has spread, as the focus will move to dealing with the metastasis, but really now the focus needs to be on the proper diagnostics.

      Hope this information is helpful and please know that there are plenty of men here who have been where your father is and that this community is here for both you. Please feel free to keep us updated and to ask additional questions as more information becomes available. Best, Richard ( Team)

    2. I agree with everything gamer says. I was diagnosed at the beginning of 2022 with Gleason 9. I had a robot-assisted radical prostatectomy three months later (stage 2, clean margins, no lymph node involvement). My PSA was undetectable until about 15 months later, then began to rise fairly quickly. My PET scan was negative, but as a precaution I've begun both radiation (33 sessions) and androgen (testosterone) deprivation therapy (which is somewhat unnervingly--and misleadingly, because it's reversible--known colloquially as "chemical castration"😉. I worry about recurrence, of course, but I'm trying to take it a day at a time (hard for me, because I'm a chronic worrier and glass-half-empty guy). My 25-year-old daughter asks me from time to time whether I'm going to die. (It's how she deals with her own worrying.) I always reply, "Yes! But not anytime soon." Then the future feels manageable again, and we move on.

  2. , Thank you both so much for your time spent responding to me. It is good to hear that there is some hope for management of PCa, and good to hear of a personal story too , you have given me some hope. We have the PSMA Pet scan on Wednesday and we are praying for the best outcome.

    1. please keep us posted on the scan on Wednesday, we will be thinking of you and your dad. Sending you both lots of strength. Jill, team

  3. I was diagnosed in 2013 with a Gleason 9 and now some 11 years later I am still here. I suspect the best approach is to be sure your dad is being cared for at a major cancer treatment center vs a well-meaning local treatment facility and team. Dennis( TEAM)

    1. Well an update for you all, yesterday we received the news that dads cancer was advanced metastatic disease. I think on the whole it was probably the worst day of my life so far. I should advise that we are in Australia, but now we are looking for what comes next. Can anyone provide any assistance or hope? Thank you

      1. I can't even imagine how difficult this is for all of you. I am sure this is so devastating. I am sending you over a couple articles that I hope can be helpful for you:,, and I am sending over lots of hugs and strength to you. Please reach out and let us know how else we can help. Jill, team

      2. Sorry to hear the news on your dad ... I am not familiar with the various types of medical treatment centers in Australia.

        A PMSA PET scan recently found distant cancer in my hip bone and it was successfully treated at a major cancer treatment center with Stereotactic Body Radiotherapy (SBRT) My local regional hospital did not offer that option to me and it was the reason I looked elsewhere.

        You may want to consider exploring various treatment options at a highly specialized cancer treatment center in your area. Please keep us posted as your experiences can be of help to many other men and their families as well . Dennis( TEAM)

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