Hi everyone. I wish I were back here with better news. Thank you again for the kindness on my last two posts — I genuinely don't know how I would have gotten through these past few weeks without this community. [Previous post for reference]

I got the results of my father's Ga-68 PSMA PET-CT scan today. I'm going to lay it out as clearly as I can, because writing it out helps me process it, and I know some of you are in similar situations and appreciate the detail.

The TL;DR: The cancer has spread beyond the prostate. It has invaded neighboring organs, reached the lymph nodes, and spread to multiple bones. This is now confirmed metastatic prostate cancer. He is 56 years old.

The urologist is suggesting removing the testicles to reduce the PSA level, then proceeding. I can share scans in DM if someone is willing to give a second opinion.
What should be the line of treatment?

Location: India

The Primary Tumor: The prostate mass is large — 5.5 x 5.8 x 6.8 cm — and is lighting up intensely on the PSMA scan (SUVmax 13.1, for those who know what that means). It has grown into the urinary bladder, both seminal vesicles, and the rectum. There's also a part of it pushing outward toward the right side of the pelvic wall.

Lymph Nodes: The cancer has spread to lymph nodes — aortocaval, bilateral internal iliac, and right intergluteal nodes. The largest is about 2.0 x 1.2 cm.

Bones: This is the part that hit hardest. There are cancerous lesions in multiple bones — the sacrum, right ischium, right pubic bone, right ischiopubic rami, left acetabulum, and right iliac bone. The SUVmax in the right iliac bone is 31.0, which I'm told reflects very high metabolic activity.

The rest of the body — lungs, liver, brain, chest — appears clear.

Previous Post for reference and context

Update: Did a PET-PMSA scan today and am waiting for the results.

TL;DR: The biopsy of my father confirms aggressive prostate cancer (Gleason 8, Grade Group 4). It is present in 100% of the sampled tissue across both lobes. While it shows signs of following nerve pathways (perineural invasion), it hasn't been observed breaking through the prostate wall in these samples.

Hi everyone, thank you so much for the support on my last post. It kept me going while I was waiting in the dark.

The Clinical Details:

• The Diagnosis: It is an acinar adenocarcinoma of the prostate.
• The Grade: It’s a Gleason Score 8 (4+4), categorized as Grade Group 4. This confirms it’s an aggressive, high-grade cancer.
• Extent: It is extensive within the organ. All 12 out of 12 biopsy cores were 100% involved by the tumor, affecting both the left and right lobes.
• Spread: The report mentions perineural invasion, indicating the cancer is following nerve pathways. The pathologist did not identify "extraprostatic extension" in these samples, meaning it hasn’t clearly burst through the prostate's outer capsule in the areas they tested.

What should be the ideal line of treatment ahead?
I am checking with the urologist and oncologists for their opinions before moving ahead.

Hey everyone,

I’m sitting here alone, trying to process the situation. My dad’s (56) PSA level is 838.49. I haven't seen anyone talk about a number that high, and I am spiraling.

He was rushed to the hospital with kidney pain because his prostate was so enlarged that it blocked his entire system. He went through emergency dialysis, and his creatinine peaked at 12.4. While his kidneys have fought back and stabilized at 1.5, he is now severely anemic and weak.

He’s a chain smoker and a regular drinker, but he’s always been the "healthy" one who didn't get sick. We are now waiting 3 days for biopsy results to confirm where it has spread.

I am doing this all by myself. I’m trying to stay strong for him, but I’m breaking down in private.

• Has anyone seen a PSA this high and still had years of quality time?
• What does the "process" look like from here? I need to know what’s coming so I can prepare.
• How do you survive the wait for the biopsy results?

I just need to know there’s a light at the end of this.

Please share your stories. I really need them right now.