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What to do? Post RP, Gleason 9, Prostate ductal adenocarcinoma
Prostate Cancer | Last Active: Nov 8, 2025 | Replies (59)Comment receiving replies
Also, his PSA levels prior to all of this were all in normal range. Age 67, PSA level once considered abnormal was 5.75 up from 4 and change. Primary doc was closely monitoring as he was on implanted testosterone.
My point is, his PSA levels never were very much a concern until they were. Most likely, aggressive cancer had been brewing for quite some time. No real other symptoms other than what he chalked up to be aging (more frequent urination, weaker stream).
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@sriddle1
Hi,
I am so sorry that your and your partner have to go through PC diagnosis. I understand your anguish since I am here also representing my husband.
At this point results of PSMA test are very important and with aggressive features of IDC and cribriform his Decipher test results would probably be very high. PSA for aggressive cancers often can be almost in a normal range, that was the case with my husband too. He had RP surgery about 10 weeks ago and his gleason score jumped from 7 unfavorable found in biopsy to 9 after complete pathology was done. Our urologist told us at the last meeting that aggressive cancers very often produce less PSA than gleason 7, which should be a cautionary tail to newly diagnosed or to people on AS and I do not know why that fact is not more discussed or more known.
Since your partner's cancer escaped the gland to lymph-nodes and to bladder neck and vesicles, it would be unusual that his PSA comes back undetectable and you should start exploring next steps that will be taken in near future - such as salvage radiation , ADT and possibly even chemotherapy.
If possible, go to Cancer Center of Excellence for a second opinion since your partner needs full supervision and care of a whole team of doctors and I do not understand why your hospital arranged the first post op with a nurse for a patient who has those agressive pathology findings : (.
This is all shocking, I know, just try to keep in mind that there are so many new and effective treatments available for every stage of this awful cancer and we here have many members that went through treatments with excellent results. You are doing great thing by doing your own research and trying to be informed and that is the best way to go forward ! Unfortunately that is the ONLY way since than one can demand AND get the best possible treatment with the best possible results.
Wishing you the best of luck and sending hugs < 3