Brother has been diagnosed w/gleason 9

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New Member

Date Joined Apr 2011
Total Posts : 2
   Posted 4/27/2011 7:52 PM (GMT -6)   
I am new brother, 85 , has been diagnosed with pc, gleason 9, metastasis to bone ( 3 vertebrae).pSA 25. Doctor has recommended hormone therapy. No radiation yet. Should I be asking for radiation or chemotherapy? How grim is the situation once it has spread to bones? What is the prognosis? Any insights would be very helpful. thanks so much.
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Post Edited By Moderator (Steve n Dallas) : 4/28/2011 3:32:21 AM (GMT-6)

Veteran Member

Date Joined Apr 2008
Total Posts : 847
   Posted 4/27/2011 10:29 PM (GMT -6)   
As the PCa has already spread, that rules out radiation to the prostate, but not radiation to relieve pain from the bone mets.

Hormone therapy (or actual castration) would be the normal treatment at this stage, and may have dramatic effects. Chemo is probably not warranted at this stage until the doctors have confirmed HT is not working. Even then, there are quality vs quantity of life issues that each patient has to consider.

Sorry, the prognosis is not good, but with HT, another five good years are possible, and at 85 I'd grab it.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4/12 cores
Non-nerve-sparing RRP 7 March 2008 age 63
Organ confined, neg margins. Gleason downgrade 4+4=8
Fully continent
Bimix worked well; now using just VED
PSA undetectable at first but now 0.4, doubling time 7 months
No radiation but ADT coming unless I can slow down the rise...

Elite Member

Date Joined Oct 2008
Total Posts : 25380
   Posted 4/27/2011 10:32 PM (GMT -6)   
hello and welcome, omk.

sorry about your brother's situation. at his age, and with that prognosis, i agree with piano's accessment for limited treatment choices, and t his assumes your brother's health is up to any of the suggestions. i wish him, and you luck ahead.

please stay with us and keep us posted.

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 4/28/2011 5:29 AM (GMT -6)   
Welcome to the forum. You may find it helpful to read some of the journeys of other Gleason 9 fellas here on the YANA site at the link below. Click on the "8 or mores" and then scroll down to the "9s". If you click on their name their personal story and treatments and successes will come up. In most cases you will see a response when HT is started. It is usual for the tumours to shrink as normally (at least in the early stage of treatment) PCa needs testosterone to flourish. Hormone treatment deprives the tumour cells of the testosterone needed for growth of the tumours. Often radiation to spots on the bone is given to reduce the effect of tumour and pain at those areas.,name&desc=Gleeson+Score


Veteran Member

Date Joined Jul 2009
Total Posts : 1267
   Posted 4/28/2011 6:59 AM (GMT -6)   
Omk, I'm sorry to hear about your brother. While his stats and his prognosis may not be good PCa is often a very individual disease where some with good stats do poorly, and some with truly terrible stats do far better than expected.

Your brother likely has treatment options available which may slow down the progress of the disease so well he eventually dies of something else. That's what happened to my father.

I do hope you'll keep us informed as to what he decides to do, and how he's doing.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02

New Member

Date Joined Apr 2011
Total Posts : 2
   Posted 4/28/2011 9:40 AM (GMT -6)   
Thank you so much everyone and thanks Bill, for the YANA site. Just reading all the posts on this forum is so very helpful and hopeful. I will definitely be here awhile.

Veteran Member

Date Joined Jul 2010
Total Posts : 3748
   Posted 4/28/2011 10:39 AM (GMT -6)   
There is a chart in Dr. Walsh's book, page 479, something like that, that graphs life expectancy for PC victims when bone mets are found..Briefly, the numbers are: 10% die within a year..10% survive 10 years or more..80% fall somewhere in between, with 70% having passed by the 5th year..

Since your brother has never been on "Hormone Therapy", his cancer is likely to have a big, positive, response to this treatment and if that is the case, his prognosis will move towards the top end of this chart...

Hormone Therapy can take many forms, but the goal is always the same, to lower testosterone levels as much as possible. Physical castration is the most effective "hormone therapy" and also the cheapest, with no drug related side-effects. Very few men opt for that method however...The man you want to talk to now is a Medical Oncologist who specializes in treating prostate cancer...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0
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