A friend with Gleason 9

I haven't been here for a long time but I just found out that a close friend was diagnosed with Gleason 9. He is 80 years old and not in very good physical condition. His biopsy report Is the worst I have ever seen. 12 out 12 cores positive for cancer (4+5) and (5+4) with volume between 50% and 100%.. He is the process of getting an MRI and bone scan. I recommended that he should see a prostate oncologist. I'm assuming that he will be put on (ADT). Is there anything new that he should be aware of? Any help is appreciated.

Ed,
If they do decide on ADT, it has been determined through numerous studies that adding Zytiga, Xtandi, or Erleada early - while the patient is still hormone sensitive - leads to significantly better outcomes.

His PSA at the time of the biopsy was 11 which is not high considering the amount of cancer in his prostate. Thank you all for responding.

Thinking of your friend.

Here's hoping a treatment path can be suggested ... many of us here faced some sobering news at diagnosis, but treatments can help, and create a meaningful response.

My first two months of ADT shots brought my PSA down from over 100, down to double digits, then single digits, and then the decimal range.

My initial treatments brought me what I needed most ... a sense of hope.

Medications such as XTANDI or ZYTIGA can easily be taken at home, and these can trigger a meaningful response, as well. Your friend definitely needs to add an oncologist to his medical team.

My treatments have helped me, my doctors have been a Godsend, but more than anything ... the care and compassion of family and friends has been paramount.

Sounds like your friend is lucky, indeed, to have a friend like you!

You can be there to support him, encourage him on tough days, and help him navigate through his upcoming tests, and subsequent treatment plan.

In my life, there's nothing better than a friend who becomes a BROTHER or SISTER, in a time of need.

Let us know how your friend is faring --- hoping a treatment path can be mapped out.

Thanks for being there for your friend,
Cyclone - Iowa State University

what is he thinking of doing...if anything...

The usual advice we give newly diagnosed guys is to slow down, do their homework, and not to rush into any decisions, because prostate cancer is a slow-moving disease. That may be so-so advice for your friend. With well advanced Gleaon 9 (5+4) disease he needs to start treatment quickly and keep up the tempo until he finds a treatment that works.
The first step is to find a good medical oncologist who is expert at prostate cancer. The second step will be some combination of imaging and androgen deprivation therapy. There is considerable urgency to start the ADT but prolonged ADT can interfere with some imaging technology so he should get his MO to help determine the order of events.
If his chosen MO can't see him fairly quickly he might ask the MO's office to leave a note for the doctor asking whether it would be sensible for his urologist to give him his first ADT shot while he waits for his appointment.

Hello All! I'm a bit of a novice with posting in the forums but all the threads I've been reading have eased my mind a bit. My story, diagnosed 2 years ago with a G9, Mets all over but no organs affected, PSA 261. Started Lupron, Zytiga and Prednisone and gained undetectability for 6 months. Now CRPC and getting ready for Taxotere in a few weeks. Also HIV+ since '97. I am 56 years old and still working as a construction (asphalt) senior project manager. My company supports me fully and has reduced my level of responsibility to some degree to allow treatments and 'fog timeouts' whenever needed. I appreciate the comfort so many of you pass on to each other and the advice will be well taken. I need your guidance going forward and certainly will be indebted to all the Warriors who I can tag along with throughout the new paths of journey. dTk.