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

Welcome
Good luck with your treatments and stay strong!

Would like to share my experience. You could use as input for your decision making process. I am 48 yo and had a gleason 3+4 (10% pattern 4) with no ECE. I had a RARP on july 16. The pain was mild, and tylenol was enough. I removed the catheter last wednesday with no incontinence issues. Just saying that the surgery is not that bad and side effects are bearable. Good luck to you

My biopsy showed 2 cores of cancer; one at 3+4. After consulting with 2 doctors, friends and family, I decided on Surgery. I, like many others, just wanted the cancer out of my body. After surgery, my pathology report came back as 4+5, NOT 3+4. My advice to you is make sure you are completely confident that your scores are correct. BTW, so far, almost two years later, I never had incontinence issues and I have had undetectable PSA scores of < 0.01. As somebody else said, the surgery is not that bad, especially if you are in good health and take care of yourself. And choose the best surgeon possible. I was 71 when I had mine. Best of luck in whatever decision you choose.🤞🙏

I too met with Dr Pow-Sang at Moffitt to discuss focal options for my 3+4=7 in one core of MRI Guided 13 core biopsy. My PSA was 4.5 in February ‘25, MRI in March showed PIRAD 5 lesion inside prostate only which measured 2.2cm, and targeted biopsy in April ‘25 confirmed it. I Had CT with contrast and PSMA PET showing the cancer was contained in gland. I was interested in IRE as well. Anyways Dr Pow-Sang told me my lesson was too large for focal therapy and if they did one he said the chances of reoccurrence would be 50/50. He also said any focal therapy has a much higher chance of coming back at some time, and also requires lots of follow up like 3 mos PSA blood tests (not bad) and 6 mos biopsies. He said it would be like kicking the can down the road in his words, at least in my case. He suggested whole gland radiation treatment for me. Another interesting fact just happened. My Onocolgist ordered another PSA blood test since my last was in February ‘25 and it went down significantly!?!?! I was a 4.5 in February and the other day (7/31) I am a 3.2?!?? That’s almost a 30% reduction? Has anyone heard of this happening before? All my PSA tests have been done at Quest so the same lab. That just seams like a large reduction for a recently diagnosed cancer through both MRI and biopsy.

My husband's PSA went from 7.6 in January to 5.1 in April (or May, forgot when he had test again) and it stayed there so far ( now 5.6) but it does not mean anything . I am 100 % sure that his gleason is the same and that cancer is still intermediate unfavorable. PSA can go up and down and for my husband in general went up and down through the whole period of AS. BUT, over 10 years of AS the trend was upward and also the biggest drop was always immediately after a biopsy - perhaps biopsy sample lowered tumor burden, however small sampling was ?

Simply having sex within a week of the PSA test can affect the results.

That would raise your PSA

The problem with a Gleason score..."any" Gleason score...but especially a lower/moderate score, is that you really know nothing about your cancer. I am a Gleason 3 + 4 = 7, that at the time of biopsy and in the post-radical prostatectomy showed only 6-10% "4" cells. I was barely a 3 + 4 = 7...as close as I could be to a 3 + 3 =6. But...and that is a big "BUT"...my urologist said flat-out: "I'm taking your prostate...there is no logic or purpose to 'wait and monitor' with active surveillance, because all you are doing is waiting for the inevitable of the cancer progressing to something worse", to include everything I will describe below:
My urologist/surgeon and I went into surgery confident that we had "caught the cancer early", and we did in one sense, but...the Gleason score says nothing about the microscopic cellularity and molecular level data. That is why getting the "Decipher Test" at the time of biopsy is important. I was not told back then that my insurance company would not pay for the Decipher Test. I was not given the information so I could decide to pay cash for the test. Well, everything changed after surgery in the surgical pathology report:
I had Extraprostatic Extension (EPE) of the tumor. I had "Surgical Margins" meaning the physician didn't get all of the tumor tissue/cells, out of me; I had Cribriform glands (ominous issue of cells in sheets that look like Swiss Cheese as one author describes it); I also had left seminal vesicle invasion which instantly changed me to be a pT3b category, despite my Class/Grade "2" and Gleason Score of 3 + 4 =7, again with just 6-10% of cells being grade "4." The invasion into the seminal vesicle makes you the pT3b and lowers your longevity from 10-15 years or more, to more like 5-10 years "if" you are properly treated. A pT3b cancer just "always comes back"...reoccurs ... within the first 5 years. It could happen 6 months to a year later, or might take up to the full five years. Either way, the vast majority of pT3b category cancer reoccur.
So, that was a long story telling you that a Gleason Score really tells you nothing. It is more valuable the lower the score is, telling you that you likely do not have cancer, or if you do, it may very well be early in its stages, and easily treated with good outcomes. It seems though that once you are at a "moderate" risk 3 + 4 = 7, or worse...a 4 + 3 = 7, it is a crap shoot. You really do not know, as I didn't, how severe and aggressive your cancer is, until your prostate is removed and you get your surgical pathology report that gives you...or spares you...the bad news. Get that Decipher Test done. It can still be done on your biopsy tissue. You'll have a better chance of knowing how aggressive your concern is or isn't.

Life seems to dictate that “we live until we die”. Still, we try to control its course and get terribly upset when things don’t go according to plan. Perhaps if we stopped trying to control it we might find a place of peace.
All the best to you on your journey…