I am 77 years old and Gleason 9 and for the last 3 years I have been treated at UCLA with RP, a year of ADT and Erleada. If I were in your situation ( and indeed in time I maybe ) I would ask my physicians about triple therapy of radiation+ADT and Erleada and perhaps chemo. It appears that you have a high risk, aggressive and advanced cancer and aggressive excellent treatment is appropriate, subject to other health issues. Good Luck.