44yr PSA180 Gleason9 non-metastatic. Surgery or Treatment?

Posted by dinu @dinu, Aug 29, 2025

I am 44 yr old, Navy Veteran, just got diagnosed with prostate cancer. First rectal exam showed enlarged prostate, followed by PSA180. Biopsy showed 9 out of the 12 samples with cancer cells (most of them Gleason8 or 9). MRT shows no spread. CT with contrast shows no spread. I just got today my bone scintigraphy. Initial results show no spread. Father had prostate cancer last year, therapy, seems to be cured. Mother has breast cancer and stomach cancer (surgery and treatment) now cured.
My big question now: should i go for complete prostate removal or should i go with the various other treatments?
I am currently being seen for this at the University Clinic of Heidelberg in Germany.
Appreciate all the support and stay positive.

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jeff Marchi | @jeffmarc | 5 hours ago

Great to hear your testosterone is going down with Firmagon. That’s what the people at the online Ancan.Org Mutation meeting said would help, It appears to definitely work.

A PSMA pet scan would probably cost you $4000 to $6,000 or more in the states. Much cheaper to have it done in Europe.

Really interested in hearing what your second PSMA PET scan shows.

The somatic genetic test is really a good idea to get so it’s good to hear they’re doing it. It can actually show genetic issues in your metastasis that are different from the genetic issues in your hereditary test. I know people that have it show BRCA2 and they’ve been able to take PARP inhibitors as a result.