If you have one Gleason 8, you are a Gleason 8. That means your cancer is pretty aggressive and you should do something about it soon. What was your PSA?

The first thing you should do is the PSMA PET scan recommended by your doctor? That will show you if your cancer has spread and you have any metastasis.

Based on what they find, you have a choice of either radiation, surgery (a prostatectomy), or a few other treatments that are available. When you find out more information, come back and tell us. Many people here will have recommendations for different types of treatments based on your results.

A lot of times when you are a Gleason eight, they want to put you on ADT right away to stop the cancer from spreading and growing. That usually means a Lupron, Eligard, or firmagon shot. You can also just take an Orgovyx pill, which does essential is the same thing. Because you are a Gleason 8 they normally want to keep you on ADT for 18 months (NCCN guidelines).

Surgery is definitely just an option at this point. If it is not spread out of the prostate, you probably can avoid surgery..

You should also get genetic testing. That will tell if you have a problem with your genetics that could make the cancer even worse over time. You can get it for free by going to. Prostatecancerpromise.org I don’t pick the option that you want your doctor involved or they won’t send you the spit tube that you mail back. In 2 to 3 weeks you’ll have results and they will have a genetic counselor discuss them with you.