Is anyone with Gleason 4+3=7 trying active surveillance?

I decided to seek SBRT radiation for my Gleason 4+3 situation. I'm 63 and had a PSA of 8.1. My biopsy had 13 total cores. Only one core had 4+3 with eight other cores being positive for Gleason 3+4. Of the eight 3+4 cores, half had 40% of pattern 4.

The Gleason 4+3 core was the biopsy target. It also had tumor contact with the margin of the prostate gland but no evidence of macroscopic extraprostatic extension. This was, fortunately, confirmed by my PSMA pet scan test.

My primary reason for selecting SBRT radiation (instead of surgery) was because of my concern with possible microscopic extraprostatic extension from the Gleason 4+3 core. If true, then I believe the SBRT should be able take care of the microscopic extraprostatic extension. My SBRT radiation treatment begins 10 days from today.

My husband is 4+3 and oncology prostate surgeon said that he should start thinking about the treatment since 4+3 is not candidate for AS . I mean we WANT treatment ASAP - we would have had it if 3+4 was ever detected, not to mention 4+3.

I was 4+# w/cribiform. I spoke with 5 doctors. Each explained to me that the cribiform took me out of AS possibility. However, my circumstance, (PSA 8.6, 5/15 positive, all in identified lesion area and only 2 that were 50% 4, and a primary single lesion of 3mmx3mmx7mm , negative PSMA, intermediate decipher, no mutations on germline tests, it was felt that ADT wasn't necessary.
The cribiform was definitely a negative, but combined with other "positive" factors, it was felt that SBRT at 37.5 gy should provide sufficient tumor control.
PSA has not behaved like I had hoped.- a 3 point spike immediately after treatment, then a 60% drop by 6 months, followed at one year by the "radiation bounce" but the trend has overall been down, so MO and 2 RO's feel that at this point treatment was effective, but I may need 2-3 years to nadir.

Kudos for knowing what you want out of life.

Cribriform may still be in your future. Reports are shown that you cannot remove all of cribriform With SBRT radiation. It needs further treatment to completely remove it, Usually brachytherapy is done to finish it off.

Many hospitals are doing HDR brachytherapy plus SBRT with hormones. The idea is that the short term high intensity boost given with the seeds (maybe an hour) really gives those aggressive cribriform areas a beat down. Then, 5 sessions of SBRT (MRIdian, Cyberknife) takes care of the rest of the gland and margins.