Hi Mjp, so sorry to hear that you have to deal with heart issues on top of this diagnosis. Other members here have much more experience and knowledge about gleason 9 cancer with local spread, so I will let them chime in about that.
I just wanted to say that perhaps you can consider inclooding swimming in you exercise routine. It is relaxing, low impact, engages all of the muscles and it can be adjusted to the level of what is comfortable for you. Also, cool water may help with possible hot flashes that sometimes appear as side effect of ADT therapy. By the way, you are really doing great job with long walks 🙂
I am glad that you found this forum and I am wishing you very successful and complete eradication of PC . It seems that you have a good team of doctor's so far. They were very fast to act and ordered all necessary tests and were proactive with putting you on Orgovyx immediately. You can always ask for a second opinion and visit ( if you can ) a big medical center designated as "Cancer Center of Excellence".