Gleason 9 is serious business. I know that from experience. I’m told that the typical standard of care now is RT to the prostate bed and perhaps lymph node basin and up to two years of first and second generation ADT. I am on first generation ADT, Orgovyx and second generation ADT, Zytiga. I went into this in excellent shape for being 69 years old and continue to exercise every day, including resistance training, which has helped minimize muscle loss and weight gain. My prostate bed was previously radiated when I got received low dose brachytherapy in 2020 so that can’t be repeated for me, but it might be part of our standard of care plan for you. I’m currently undergoing 33 sessions of VMAT format IMRT on the lymph node basin only. My PSA is currently undetectable.

Not sure where you live, but I strongly suggest that you consider making certain that you’re getting care at a center of excellence even if that requires travel. My initial care was not at the center of excellence and I underestimated just how important it was which is why I share these thoughts with you.

Best wishes for success on your journey.