Poor prognosis

Twiggy, one problem about RT spread widely enough to deal with the PCa in those lymph nodes is that it may have unwanted effects in the bowel and bladder unless directed with extreme care. I would talk to the Oncologist about that.

The HT should cause the prostate to shrink and the TURP of course will possibly remove some cancer, depending on the PCa locations. When things have settled down, the RT could be applied. I would say that you probably have some months to think about the RT option.

I was also a Gleason 9 with a high PSA over 11 years ago (I am 75 now). I had no evidence of widespread mets, nor indeed spread to lymph nodes, but realistically micro mets anywhere are possible with a Gleason 9. They may be too small to show on scans. I have now a met in my urethra to illustrate that point. I had RT to the prostate and seminal vesicles. I also had some later specialised brachytherapy to my urethra, but the little blighter survived that.

I offer this to suggest a sense of realism but also hope, that Bill should have more than 10 years of a good life ahead - and I hope in his case and mine, much more!

AC

Hi Twiggy,

My husband is similar in diagnosis.

As far as I understand radiotherapy is given with curative intent. Perhaps the 2~3 years meant the time on hormone therapy which makes it more effective? 

If lymph nodes are within pelvis it's classed as locally advanced which you can read a fact sheet about on this website which I found useful. 

I have the same diagnosis as your OH Gleason 9, 4 + 5 T3b N1 M0 lymph node involvement and spread to seminal vesicles. I am 51 and I feel very well having completed 37 RT treatments last summer. I have just less than 2 years of hormone therapy remaining. I had 2 days off last year, I travel with work and I am back on a training regime which is making me feel great!

I think Gemma is right about the 2-3 years being the hormone therapy duration.

Richard