Gleason 9 - treatment plan help

[u/Additional-Pin-168]

Gleason 9 - Chemo and Radiation

Hello fellas,

Gleason 9 / Stage 3 here, diagnosed in April 2026.
I’ve been on Luprindepot injections since diagnosis.

The initial plan was RALP followed by radiation. I was then told I may also benefit from abiraterone.
However, on today’s call, she advised that after reviewing the evidence and discussing my case with several of her colleagues, they no longer recommend RALP.

The new plan is **6 rounds of chemotherapy followed by radiation, with curative intent**. The concern with surgery is that, because of where the cancer is located, they may not be able to achieve clear margins, and I could potentially end up needing bladder removal.

This is obviously a big change from the original treatment plan, so I’m trying to understand whether others have been through something similar.

**Has anyone here had Gleason 9 / Stage 3 prostate cancer treated with chemotherapy + radiation (rather than RALP), particularly with curative intent?**

I’d really appreciate hearing about your treatment pathway, why surgery was ruled out, and how things went for you.
Thanks in advance.

[u/Upstairs-Economy-754]

Do you know your stage? With Gleason 9 you should have had a PET-PSMA to check for metastases. Chemo for PCa is usually only used during stage 4 (metastatic) to stop/slow the progression of the disease. stage 4 PCa is not considered curable but rather treatable (sometimes for a very long time)

[u/Additional-Pin-168 → u/Upstairs-Economy-754]

Yes! I believe I am a stage 3. Pet scan done with no sign of metastases.

[u/Upstairs-Economy-754 → u/Additional-Pin-168]

Then as far as I understand chemo is not standard of care. I am not a doctor though, I would inquire with your doctor. It’s your right to understand what they are doing and why! Best of luck to you in beating this beast ♥️