My Gleason score is 7 - 3+4. How long can I live without treatment?

I was a 7 (3+4) April 2021 and had the robotic surgery. They took out everything. Three of eleven lymph nodes they also removed tested +, so fall 2021 I had seven weeks of radiation, and Luprin (sp.?) shots every six months. So far, bone scans are clear and my blood tests measure 0. But the effects of no testosterone start off subtly but become significant—low energy, no sex drive, immense depression. Lesson: you can survive the treatment, but can you survive the recovery? I struggle emotionally and physically daily. Not sure I’d go through it again.

That seems like a lot of treatment for a 3+4 Gleason, but I'm new to this message board
I recently had a parametric MRI that showed PIRADS 4 and a 12mm lesion, also a 95 on the 4K score I am having a fusion biopsy in a week. I am 70 years old, and I will not consider surgery, unless Gleason 8 +
My Dad had PC at age 63, had a Radical Perineal Prostatectomy in 1984, much different than today, with advanced techniques. It left him impotent for the rest of his life. He was treated at Mayo, they also did an orchiectomy ( removal of testicles) and put him on Casodex? and other hormone blocking drugs. They did not get all the cancer with the RP and it eventually spread to the bone, but he was 90 years old at that time, and he actually died from a sepsis infection. The hospital doctor and my Dad decided not to treat, considering that bone cancer death would have been more painful and drawn out. My Dad was always cheerful, had 65 people at his 90th birthday party, played golf until age 87, and generally enjoyed life. I don't think I would be as resilient

My Gleason is also 3+4= 7 with MRI, biopsies, and PSMA prior to starting treatment (ADT) in August, 2023. Did Casodex for 30 days and had my first Bupron P injection. The first 2.5 months were dreadful: no energy, hot flashes, weight gain, loss of libido, and more. Then, for whatever reason, all those symptoms dissipated. I had my second injection, being on the 3-month regimen, without the symptoms returning. My 3-month blood test revealed a testosterone level of 10 and a PSA of 0.05. My urologist wants it to be undetectable, so will have my second blood draw mid-February when I will also have my third injection. Since Bupron is time release, I attributed the symptom decrease to that as the 3 months were coming to an end, but the fact that they did not return with the second injection was very encouraging. Go figure, but it underlies the fact that none of us will react the same to the many treatment options now available.

Agree with other post. Maybe more to it. 3+4 without other important factors likely would not require that much treatment. Best to you going forward.

Dear MitchM and Ranger44,
Of Course, you can and will be resilient and survive, even thrive, in our new life! Don't let the trials of PC, Winter Doldrums, our National Politics and Our Warring World completely drain your souls from the joys and wonders of Life! I'm appreciative of both of you posting your thoughts and feelings. As my father would say to all of his 12 children at the dinner table, "It's never as good as it looks or as bad as it seems." We live in the Greatest of Nations, at one of the greatest times in His/Herstory. The BEST for the World is yet to come with Our American Ideals, Industrialness and Optimism! Stay Strong My Brothers, the Future Looks BRIGHT! God Bless you both and all in the World.

mayoclinicadvice23: here is a link to the patient guide from nccn.org that includes your risk group, which was also mine. Doctors DO follow these guidelines and use their experience to adjust but seem to stay pretty close to what is suggested. My RO adjusted her treatment by suggesting that I do not do hormone therapy even though my psa was 10.2. The Decipher test helped lean her in that direction. One RO recommended active surveillance. I thought the guide was helpful and provided perspective and a feel for things to discuss. As my RO recently said, we, the doctor community, make educated guesses. Her education was at MD Andersen. There are pluses and minuses in prostate removal as well as the different types of radiation machines, both of which can impact quality of life. "Cure", risks and quality of life were my focus.
https://www.nccn.org/patients/guidelines/content/PDF/prostate-early-patient.pdf.

Yeah, my tumor was odd shaped, evidently, and had protruded into my bladder and perhaps elsewhere. I’ve been in Lupron induced “menopause” since—like others have said, hot flashes, low energy, depression, etc. I sure wish Mayo had a face-to-face actually support group so we could all meet for coffee, share, support one another.

Hey @mitchm, you're not alone in struggling with the after effects both physically and emotionally after treatment. You may wish to join this related discussion:
- I've lost all motivation, no sex drive, depressed. Ideas?
https://connect.mayoclinic.org/discussion/new-to-group-2/

I would definitely recommend treatment. I went with a Radical Prostatectomy (Gleason 7 - 4/3) at a center of excellence, and worked to find the best possible doctor at that center. The outcomes from treatment can be positive or negative, but far higher chance of a negative outcome if you don't go to a center of excellence and do your part on follow-up therapy & exercises.

Leaving prostate cancer in your body will lead to ultimate metastasis. This will most likely cause a significant reduction in your quality of life and possibly end your life far earlier that if you had the PC treated. For myself, if I am on a train track and I see a train coming my way, I get off the train track to avoid almost certain pain/agony/potential death.

I believe it is imperative that you go into you treatment decision with a positive attitude. Your attitude will impact your recovery and quality of life.

As I said, I went with a robotic radical prostatectomy. I wanted to remove the known cancer from my body and not have cancer accidentally left in the prostate, seminal vesicles, or prostate bed. Not to say a RP guarantees that all known cancer is removed, but gives you the best chance. I chose not to go with alternative treatment because I wanted to leave that as an option if the RP did not fully remove the cancer and I did not want to risk all the negative consequences of radiation, ADT, etc... Fortunately, most men are happy with the treatment they chose, and this shows that they went into their decision with a positive attitude and are willing to deal with any consequences.

Bottom line, I can't imagine giving up on life, not treating the prostate cancer, and mostly likely not being there for all those people that rely on me - Be it friends, family, acquaintances, co-workers, etc... I always say, don't listen to those on edge with horrifying or glorious results. Most likely, you will be in the middle of the bell cure, and have some life long consequences that you will need to deal with, but you will be alive and there for the people around you.

Good luck and may God be there for you in your decision.

Jim

Whew! I finished going over my urologist's medical records which I had requested so I could give them to another physician for a second opinion as I was not comfortable with the first doctor. I wouldn't pretend to say I understood much of it but I did gather a few things. The bottom line for me is that my Gleason score is 4 - 3. And cancer cells only appeared in two of 12 samples. My inclination is to monitor it but that may be altered when I see, actually, an NP in a few weeks. I'm nearly 82. Well I have my problems there is nothing that is likely to take my life. So even though I was told that this is a 10-year cancer, there's a good chance I've got another 15 years to go. At this point I'm having pain in my right leg 24/7, albeit mild. I have a foot drop. So I have enough problems such that I really want to avoid any procedure that might result in lifelong negative side effects. I'm always anxious to receive comments, even suggestions. And I would offer this, having read several of members posts. It would be helpful to state your age.