In October 2023, I was diagnosed with Gleason 3+4, after having a prebiopsy PSA of 7.8 and a mpMRI revealed PIRADS 3, 4 and 5 lesions (see my profile for full details).

I agree with all the previous comments regarding getting a Decipher score.

IMHO, with a Gleason 3+4 diagnosis, knowing your Decipher score is essential, especially if you want to consider active surveillance (AS).

My Decipher score was 0.22 (low risk) and the accompanying Decipher GRID report (and my urologist) recommended active surveillance.

You will have to ask specifically for your Decipher GRID report…. I called Veracyte to obtain mine….an example of a part of my GRID report is attached, including the AS recommendation based on a “clinical-genomic” model of my particular situation.

If my Decipher score had come back “high risk” (>0.60) I would have most likely moved in some sort of conventional treatment direction.

I may still have to move in that direction someday, but 21 months after diagnosis my situation is demonstrably stabilized, based on follow up PSA levels and a follow up mpMRI. Monitoring is key to good AS practice.

Another word of encouragement, with a Gleason 3+4 diagnosis you have time to do your own research to become completely confident and a layperson “expert” regarding your particular diagnosis and treatment options.

In other words, don’t let anyone push you into a decision for which you are not fully comfortable.

It’s you and your husband’s life and quality of life that hang in the balance and the good news is that you have as much time as you need to make an informed decision, after being diagnosed with Gleason 3+4.