You are a Gleeson nine which is a very aggressive prostate cancer. It appears your doctors are treating it like it’s not aggressive. Any other Gleason numbers are irrelevant, the highest number is your Gleason .

It would be useful to know exactly what the decipher score was.

Radiating anything that does not have cancer Has to be done carefully. That is what salvage radiation does as well as initial RT.. It would prevent you from radiating the lymph nodes again if Cancer appears. They frequently do radiate some lymph nodes, Discuss this with the doctors.

The NCCN standard for ADT is 24 months with a Gleason nine. The latest ASCO guidelines say that you should also have an ARSI (Zytiga or a lutamide) If you want the best long-term survival.

Combinations of ADT with ARSI and/or DOC (docetaxel have been a consensus guideline recommendation from ASCO and the American Urological Association since 2018 (2020 and 2023 for triplet combinations). These guidelines are based on phase III clinical trial findings demonstrating improved clinical outcomes, including progression-free survival and overall survival, with ADT combination therapy compared with ADT alone.

There is no cure clock. You can get remission you never can get a cure with Gleason nine. I know people with Gleason nine that have come back 30 years and 20 years later with recurrence.

Are you going to a center of excellence for treatment? It sounds like you really need to get a second opinion from a center of excellence or a Genito Urinary Oncologist. With a Gleason nine you need to be very careful.

Are you sure the biopsy didn’t find any of these things? Intraductal, cribriform, Seminal vesicle invasion or ECE. If any of these were found it makes your cancer much more aggressive