Hello Vet2,
My husband also received a similar pathology report to yours and due to the aggressive nature of the cancer, and the extensive spread throughout the prostate, we sought the opinion of several specialists, and then based on information we received and also articles/books read, we acted very quickly.
Basically we were told that my husband's best chance was to fight the aggressive cancer with an aggressive approach. All specialists stated that a multi-modal approach was best in his case. This was as follows:
Immediate start with Hormone Therapy (Lucrin injections and a short course of Androcur). This would most probably continue for about 2 years.
A TURP (rebore) - mainly for the urination problems my husband was experiencing. This was carried out in late January after 4 weeks of Hormone therapy.
High dose radiation Brachytherapy (over a course of 3-4 days in first week of May).
External Beam radiation (23 daily sessions) ten days after the High Dose Brachytherapy
It was also suggested that due to the aggressive nature of the cancer, it was extremely unlikely that cancer cells had not already escaped the prostate capsule. Therefore, all the specialists we saw ruled out removal of the prostate as they felt "the horse may have already bolted". They all felt we had the best chance with the above approach. They did however, give us the choice for prostate removal if we wanted it.
I must admit, we are very "happy" with this suggested treatment.
We decided against the Prostate removal as we thought it would only stress and weaken my husband unnecessarily at a time when he would need all his health, energy and focus for the radiation.
So far, although my husband has had some big problems after the TURP, these have now settled down, and he is feeling very well and active. In fact, if not for the diagnosis, you would not think he had any health problems at all.
His Testosterone level is falling very quickly, and so too is the PSA, which at the last count following the TURP was 2.
All specialists spoke in terms of "in the years to come", so we felt heartened to hear these words as we were not sure whether there were years to come with a Gleason 9 in nearly all of the prostate.
So, Vet2, your mental state will play a big part in all of this. I know its hard to be positive with the cards you were dealt. However, this IS the had you have been dealt, so play the game with the aim of winning, not folding. You can do it! Take a deep breath, focus and look forward to coming out on top. Anything else is not acceptable.
Good luck