Your ADT + radiation is standard treatment for a Gleason 9 (as the attached NCCN guidelines show).

However, those NCCN guidelines also show an alternative treatment of “doublet therapy” consisting of ADT + ARPI + radiation, which has been shown to result in better outcomes. A number of clinical trials have shown better outcomes with doublet therapy as well (see attached chart).

As for what to expect —> First, I would expect success. I would also ask my doctor why doublet therapy wasn’t used in order to increase the chance of success.