The only Gleason score that counts is the 4+5. You are a Gleason nine and more likely to have reoccurrence as a result. Doctors Don’t really care about the lower scores.

Were any of the following found in the biopsy like intraductal, cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions).

Any of these means that your cancer is more aggressive.

The results of the PSMA PET scan are very important. If no spread is found, and you don’t have any of those more aggressive things in your biopsy then you could choose between radiation and surgery.

I know many people with Gleason nine that have lived decades. It looks like you caught it early enough to have treatment work for a very long time.

It might make sense to get a decipher score. Even though Gleason nine means that you are more likely to have reoccurrence the decipher score can give you a much better idea about what’s going to happen.

One strange thing about prostate cancer is that it can go dormant for years. You probably seen me mention it but I know guys that have gone 20 and 30 years after treatment, with a Gleason nine, before reoccurrence.

I’m still alive 16 years after first diagnosis even though I’ve had four reoccurrences and have BRCA2, which prevents my DNA from correcting errors. With the drugs and treatments, we have today people live a lot longer than they used to.