Hi ,my OH had similar readings Gleason 4+5 (9) T3 N1M1 with spread to para aorta glands .
That was over 4 years ago ! He started on hormone injections and then 6 rounds of chemo ,which he was luckily enough to carry on working every day .He had minimal side effects,mainly fatigue.
After about the second or third chemo his PSA came down to 0.01 undetectable which it has stayed there ever since ,he is on the stampede trial ,which maybe something that you could ask about . I can’t say emotionally it’s been easy but it’s our new norm .
Once treatment has started and you see your PSA coming down it will get easier .
Keep strong there’s a lot of support on this forum .
Best wishes
Debby