G9 - help with DX

Not knowing what the urologist told you I will be simple and direct. You have a high grade prostate cancer and due the Gleason score you are in the high risk category. The bone scan has been ordered to detect any spread there as that is normally where it will first go.

The Gleason scores range from 6 to 10. Men who are G6 usually don't have to treat it. Men with G9 and 10 can be in a real fight for life.

So what to do? First be as relaxed as possible. With the modern treatments we normally have a lot of life left even with a high risk dx. First read the sticky thread at the top that is for the newly diagnosed. You need to learn more and seek multiple opinions from different doctors as there are many different treatment methods to choose from. You should get the slides read by either Epstein or Bostwick as they are the best in the business. You should also look at the ongoing thread on this forum for the G9 guys. You are one. You always measure and treat to the highest G score as that is the one that can cause the most problems. Do everything you can to best prepare you for the treatments. Diet, exercise, stress management, spiritual, relationships etc all have to be at their best to help. Be strong, but calm. Knowledgeable and diligent.

You will get great advice and support here and you will do well with your treatments.

Best wishes and let us know how we can help. Where are you located?

Polaris
A biopsy is a hollow core sampling of your prostate. Ideally the cores taken should be as long as possible. The more cores that are taken results in a better sampling of the whole prostate. I am not sure if the "4-6" you have written means 4-6 of the cores taken were positive or that only 4-6 cores were taken. It is rather unusual to see it written like that.
Prostrate cancer cells are assigned a Gleason grade which is dependent on how changed (differentiated) the cells appear microscopically from normal cells. Grade 3 are somewhat changed, grade 4 fairly changed and grade 5 are very changed.
The three results you posted means:

Core 1 : 80% of the core sample was tumour with the majority of that 80% being grade 5 cells and the minority being grade 3 cells. The grading of these cells is then added together to produce a Gleason "score" for that particular core. Hence this core overall is a Gleason 8. I believe that the pathologist has assigned the core an overall "grade4" Gleason grade --- a little unusual.

Core 2 : This core is not quite as serious. One quarter (25%) of the core sample contained tumour. The majority (over 50%) of the tumour within the core comprised grade 4 cells and the minority was grade 3 resulting in a Gleason score of 7 (the sample's majority grade is always written first; hence 4+3=7.
"Perineural invasion" means that the nerves within the prostate core samples (nerve portions are always within the core samples) contained tumour. This is not desireable but neither is it necessarily significant)

Core 3 :
As per the explanations above but with 90% of the core being tumour, the majority of which was grade 5 cells and the minority being grade 4 resulting in a Gleason score of 9 (5+4). It also showed the nerves within the core sample contained tumour.

Overall you would be assigned a Gleason score of 9 (being a 5+4)

It is certainly not a good result but a treatment plan will be developed which depends on a few more tests and scans. It might be wise though to have the cores reviewed at a well known centre. The pathologist's level of experience is very important.
You have come to a great place with fellas who have had a great range of treatments of the various Gleason scores and will tell you freely of their experiences. Good luck and success with your future treatment.
Bill