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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
@ucla2025, hi and thank you for taking the time to respond to my post and questions.
Had your husband had a PSMA scan before as well or just this last one?
We just got the results of his scan and it whiplashed us. It noted no nodule involvement nor bone or other activity only to be told today (by surgeon that did RP surgery) that th scan is only 40% accurate. Of course the actual RP pathology would be the most accurate. That did indeed verify that 2/9 nodes were shotty, SVI and bladder neck involvement. Ugh. A blow to our hope we had thought we were getting. We are of course still optimistic that the scan didn’t detect any cancer in his bones or other organs.
I sat on the phone much of yesterday persisting he be seen by the doctor that performed his surgery. They were able to get him in today. That made us both feel better about starting a rapport with an actual doctor and not just the nurse practitioner.
His next PSA test will be on 12/9. That will determine the next steps to take.
Thank you again so much for taking the time to share your experience and advice.
Kindly,
SR
Replies to "@ucla2025, hi and thank you for taking the time to respond to my post and questions...."
@sriddle1 It was explained to us that with a Gleason 9, aggressive features, and lymph node involvement, it is very highly likely there are “micro metastasis” of the PC that won’t show up on even the best scans. So unfortunately the scans don’t always tell the whole story. Hence the need for systemic medications.
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@sriddle1 My husband had a PSMA two months before his prostatectomy and another one about three months after the prostatectomy. The surgeon was able to remove a couple of positive lymph nodes but not all due to their location. So the persistent PSA after surgery was not unexpected. Keep in mind that regardless of test results, there are treatments available to help. My husband is on hormone therapy now and it is controlling the situation quite well. It’s all so overwhelming at first but you get used to it. Not exactly fun, but the shock wears off and you just get on with it. I hope you get Dr. Walsh’s book soon it’s super helpful.