I was also diagnosed at 62, I was a 4+3 after surgery. My father died of prostate cancer at 88 But my grandfather died of pancreatic cancer. I am still alive after 15 years and four relapses. You can live a long life with the right treatments.

I bring this up because a combination of pancreatic and prostate cancer may mean that you have the BRCA2 Genetic anomaly like I have. It causes those two types of cancer. Have you had a hereditary, genetic test? If not, you can get one for free here.

Prostatecancerpromise.org

They will send you a spit tube and about three weeks later a geneticist will call you to discuss the results. Do not mention that you want your doctor involved or they won’t send it to you until speaking to your doctor.

You have a Gleason 8. The other cores don’t matter it’s the highest Gleason that counts. That is pretty aggressive so you want to do surgery or radiation or other options like Focal Therapy, NanoKnife, cryotherapy, HIFU, TULSA-PRO, if it is isolated to the prostate still they work.

I don’t see a mention of certain things that Are important to know. Is there any cribriform, intraductal, perineurial invasion or seminal vesicle invasion present?

It is probably time to move beyond your urologist. A Gleason eight is very aggressive. You want to be able to speak to multiple people about what’s going to happen. A center of excellence, like Mayo, would be the best place to start. You can get yourself a good oncologist to direct your treatment since you have many options. A Genito Urinary oncologist specializes in prostate cancer, unlike a medical oncologist that works with everything.

You definitely want to get a PSMA pet scan as soon as possible. That will tell you if your cancer has spread anywhere.