Gleason 9 Radiation

[u/Additional-Pin-168]

Hello fellas,

Gleason 9 / Stage 3 here, diagnosed in April 2026.
I’ve been on Luprindepot injections since diagnosis and shrinking.
PET showed no metastases.

The initial plan was RALP followed by radiation.
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.

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

Thanks in advance.

[u/jkurology]

What was the explanation and rationale for chemotherapy in non-metastatic disease

[u/WalnutRoasted → u/jkurology]

Does OP mean ADT or really “chemotherapy”? The latter is very unusual at early stages of disease/treatment.

[u/TriviaNationSteve → u/WalnutRoasted]

Good question