Anyone beat Gleason 8 without surgery?

Posted by mistag @mistag, Jun 7, 2023

Biopsy came back with 12 of 12 positive for cancer, eight were Gleason 7 (4+3) and one was Gleason 8 (4+4). Six of the biopsies were 80% or greater. My PSA is 7.4.

I’m 60, I just started Leuprolide (Eligard) shots along with Bicalutamide daily pills. I don’t want surgery and I would prefer proton beam radiation. Anyone taking these same medications and what were the side effects?

Anyone with similar biopsy results and what did you do and how is your quality of life?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

I'm 52 and I'm taking Eligard (along with Zytiga) and the side effects are no-sex-drive, hot flashes, low energy, weight gain, loss of muscle mass, and the need for lots of sleep. Beside the libido, the rest of the side effects have the ability for management to mitigate them. I was 42 when I had my prostate removed, so my condition is a bit different than yours as I'm chasing a metastatic cancer that is in my lymph nodes.

Continue to do your research on options and you will definitely find the right path forward. It is good that you share your feelings "I don't want surgery" but I would curious to learn more as to how you have rationalized this feeling, so that we can all help with inputs to help you make the most informed decision.

60 is like the upper end of middle-age, you could live another 40 years!

Keep The Faith


Thanks for the information. I was told my cancer may have Metastasized (MRI) however CT and bone scans are clear and lymph node are normal.
I don’t want surgery because there are other options that should work with less long term side affects, so I’ve been told.


I think you are on the right track with your treatment plan. You have a high-risk cancer and addressing it immediately with ADT will dramatically slow the growth of the cancer cells. (ADT does not kill cancer cells but it does slow them down.)

I had robotic surgery when I was 48. My pathology was gleason 7 (3+4) comfined to the prostate gland. I am now 64 and when my PSA climbed to 6.6 I had a PSMA pet scan followed by a biopsy the confirmed a Gleason 9 (4+5) grade tumor at the base of the bladder. I started Eligard with Zytiga and then had IMRT radiation to the pelvis and the pelvic lymph nodes. After 37 treatments my PSA is >0.01. So, I am officially in remission and maybe even cured. (Time and PSA will tell.)

One of the sources I found was the Prostate Cancer Research Institute. They have great information that empowers you to make treatment decisions for yourself and helps you talk with your health care provider about what you want.

This is a link to one of their videos explaining Gleason 8. The video is short and easy to follow. The host is Dr. Scholz, a Medical Oncologist specializing in Prostate Cancer.

I hope this helps.


My husband had gleason 8, stage 3b. 3 consults advised against surgery, stating that his chances of also needing radiation later were over 90%.
So he did radiation, eligard and zytiga. Into his 6th month. 18 mos left on the drugs.
Some hot flashes, no libido, and restless sleeping, otherwise he is doing pretty well.


There are 2 items that I addressed regarding the biopsy and surgery. The biopsy is much more instructive than MRI etc but it is not as accurate as testing after the prostrate has been removed by surgery. Hence, you may be advised after the Biospy that your Gleason is 8 but then learn after surgery that it is really an aggressive 9. That happened to me at UCLA. Also, I was advised that if I elected radiation instead of surgery and if the cancer returns ( given enough time it always returns) then surgery to remove the prostrate would not be available. Hence, surgery first reserved more radiation options as a later treatment. Surgery and recovery are not painful but it definitely effects your sex life and perhaps, but not often, urine control. Finally, prostrate cancer is a big deal and getting treatment and keeping a good attitude is extremely important. Good luck!


I am 62 and had prostate removed with robotic surgery. My urologist advised surgery because the cancer with higher Gleason score of 8 would probably not respond to radiation. My prostate was only 25% involved and had not metastasized.
I am one month after surgery and have pretty good bladder control. Sexual function is at least months away.
Tissue removed around prostate is cancer free.
Praying for your decision and healing.


I'm 73, GS8(4+4), All my cancer was on the right side of prostate, diagnosed a year ago. Pc spread to seminal vesicles and 2 LN. Went on Zytiga and eligard. Within 2 months Testosterone and PSA were undetectable. My side effects were mild. Maybe because of my age and that I continued to eat healthy, exercise and do breath work and meditate. I wanted to just stay on the meds and avoid everything else because my results were so good. Turns out, after a few years they wont work. After tons of research and using this platform, I decided to have a robotic assisted laparoscopic, Rad PC. next month. If it comes back (50%) chance that it will, I will likely go back on the Meds, and then maybe some type of radiation. Best of luck.


At age 74 I was diagnosed in May 2022 with gleason 4+4 in two of 20 cores, and several that were 3+4 and 4+3 and a PSA of 7.7. Scans showed that it was confined to the gland but considered high risk. I considered all the different options, such as laser ablation, high intensity ultrasound, photon radiation, surgery and proton radiation. I did not want to undergo surgery and I wanted the least amount of side effects from treatment. I elected to do the 39 treatments of Proton Beam therapy which consisted of a 6 month Eligard injection 3 months before starting the Proton Beam and 30 days of Casodex with the first injection of the Eligard , a second and third Eligard injection spaced 6 months apart for a total of 18 months of Eligard hormone therapy. The concurrent 18 month ADT (Eligard) hormone therapy follows an accepted protocol for therapy along with the radiation, proton or photon. A couple weeks before beginning the proton beam radiation my psa dropped to 0.2, six months later it was 0.04 and June 1st it was 0.02. I have the last Eligard injection on June 19th with a PSA test 9 months from then. At that point my PSA should reflect the effects of the Proton beam on my prostate cancer and until then it is a waiting game. The only side effects so far from the Eligard are weight gain in my belly, loss of libido and hot flashes.


I just want to comment on a previous post. Someone said they were told by their physician if they chose radiation and the cancer returned that surgery was no longer an option. My urology oncologist told me before I left for Houston and the Proton Beam therapy, that if it failed salvage surgery was an option with him. I asked why some surgeons say previous radiation rules out a later surgery he replied it just makes it more difficult but can be done. In addition to a urology residency he did a fellowship in urologic oncology at MD Anderson so if anyone is told this by their urologist/surgeon they should seek out a urologist that does salvage surgery after radiation, preferably someone who has post residency training.


I was diagnosed Gleason 8 20 mo ago. PSA was 6.6, cancer was contained. Because of my hypertension I was not a candidate for surgery. I started Lupron in Dec 21, 20 doses of radiation in Feb 22, and will receive my last of four Lupron injections net month. The good news is my PSA is undetectable! I guess for the moment I can say I've beat it. The bad news is for me the side effects of Lupron honestly make me wonder if it's worth it. My quality of life has greatly deteriorated.
Read up on hormone therapy and decide. For me if I could do it over I would have had surgery and taken my chances of dying on the table. Best of luck.

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