I’m glad you were finally able to get these results. The fact that it has gotten to your lymph nodes means that it’s in your bloodstream and could show up anywhere if you don’t take the right drugs. You should probably be on an ADT right away. Because your cancer has already spread to lymph nodes You want to be on ADT and probably an ARS I like Zytiga or Nubeqa. Speak to your doctor and find out what their recommendations are. They’re going to be different than they originally were because you didn’t think it had spread outside the prostate originally.

Due to the spread, they usually do not do surgery. They do radiation to treat the lymph nodes and your prostate and the prostate bed. They could take out the prostate and the lymph nodes if they’re easy to get to, but that would not be a normal procedure when there’s already spread.

Having spread to the seminal vesicles, it can be more aggressive as well, Even though you already have a Gleason nine That does increase the chance of reoccurrence.

I’m glad you have all this information already and can work with the doctors to get the best treatment so that you have the best chance of a long-term survival