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

@pdcar4756 I just had a fusion biopsy. 3+4=7 Gleason. 12 cores positive with peri neural invasion and 2 benign. I don’t get to go see the Dr for another week. I am really getting anxious and nervous. I am 70 years old.

3+4 Is a very slow growing version of prostate cancer. It’s very treatable at your age with radiation or surgery. You could do SBRT radiation, Five sessions could eliminate the cancer. You have a very good chance of long-term remission.

It might make sense to get a decipher score. It can tell you that percentage of chance that you are going to have a reoccurrence.

I was a 3+4 after biopsy and had surgery, they said it was actually a 4+3 After examining my prostate tissue. I’m still here 16 years later, even though I have a genetic problem (BRCA2) that causes the cancer to keep coming back. I also had PNI, I know a lot of other people that did, it doesn’t seem to cause major long-term issues for anyone.

What I’m getting at is that you do not have a serious case and will probably live for a decade or two and die of something else.

I had 2 cores of cancer detected in my biopsy; one was 3+4. I decided on surgery since I wanted it out of my body. After my RP, the pathology report came back as 4+5. I was glad I had it done(2 years ago this past November). Today my PSA is still < 0.01. 🙏. My advice is be sure your numbers are accurate so you can make a confident decision. BTW, right before my biopsy I had an MRI which showed nothing. Even more glad I had the RP.
Best wishes!

@rlpostrp God grief who evaluated your first biopsy and was so wrong.

@ucfron
Unfortunately Gleason scores are subject to interpretation; biopsies only test a minute portion of the prostate and a post-op pathology has the entire organ. Still an interpretation.
And similar to MRI, Pet Scans PSMA scans and the like, we want 100% "mathematical" accuracy in diagnosis in every case and the facts are that such a level of precision does not exist for every case.
SRT is used when PSA is rising and there is no precisely identifiable areas of recurrence. Still a necessary decision, as in my case, where I have had undetectable PSA post SRT.

@jeffmarc I had a cyst and part of my kidney removed a few years back. I have a cyst on my other kidney and one on my liver. They say those aren’t worrisome. I was in the Marines at Camp Lejeune if you have seen the commercials. They don’t see a connection to Lejeune. Thanks for your reply.

@kennyo
I also have a cyst on one of my kidneys. No military experience at all.

It has grown from 3 mm millimeters to 8 mm in the last five years. It’s not something they consider taking out they just want to monitor it for now.

Sounds similar to your issue. I am 78 so things like this crop up.

There are a number of factors to consider regarding treatment, not the least of these is to have a medical second opinion. As Jeff commented above, you should be able to live a long time with this, but that may include having some sort of treatment along the way. I chose radiation and hormone therapy, but my Gleason 7 included 4+3 and spread to two nearby lymph nodes. Radiation and hormone therapy (ADT) have their own unique side effects. You're asking a good question: How long (and how well) will I live with this? My response would be: what's your goal? I'm 74, and I consider anything past 80 as "bonus," but some would like to live to 90 and beyond. Be honest about your desires and expectations when talking with your oncologists, and remember that you, not they, are in charge of your health. All the best for your journey, and keep coming back here for support!

I'll start with the fact that the answer to the question is: "who knows" how long you'll live. My father had prostate cancer for over 20 years. He died at age 99 years 10 months "with" his cancerous prostate. The last five years of his life were horrible. The prostate/tumor were so large that it pushed up on the bottom of the bladder, forming a round "lake" from which all urine ready to be voided, never left his body. As a result, and because of less than optimal hygiene in his assisted living residence, he ended up with what is known as a "biofilm" on the lining of his bladder - a permanent film of bacteria that repeated seeded full bladder/UTI infections every single month. Using "day #1" of a month: he'd be detected as having pain upon urination to include foul-odor urine. The staff took a urine sample day #2 and sent it to the lab. By day #9 we "hoped" to have had a result back. Then we had to wait about 2-3 days before his doctor ordered antibiotics by ~ day #12. The antibiotics were for 7-10 days. So, by day #22, he was done. The infection cleared for about 1 - 1.5 weeks, then..."REPEAT"...day #1 of the next month, he had a new infection. It was often fungal/yeast, because the antibiotic killed all the bacteria, which let the yeast take over. Then he was hospitalized because you need I.V. anti-fungal meds. There is no "pill" to kill fungus, especially when it went systemic and entered his blood stream.
A lot of that, and the extent to which it hit him hard, was because he was 95 years old, on to 99 years old. You being younger would hopefully not go through that. But I also offer a copy/paste of my story that I just posted to another similar guy who has a 3+4=7 Gleason after his physician foolishly let him go on active surveillance for two years. Now he is in bigger trouble, and my similar Gleason 3+4=7 story tells the complete fallacy of what a Gleason Score does and DOES NOT tell you. After this already long read, I apologize in advance for what follows...it is long, but offers the details about why a Gleason Score means nothing...you can be fooled into thinking your low or low-moderate 3+3=6 or 3+4=7 is "catching your cancer early", when in fact, you can already have quite advanced cancer like me. My story is as follows:
The Gleason Score tells you NOTHING about the cellular-level pathology of your cancer. The Gleason score is the small tip of a massive iceberg that lurks under the surface. Here is why I say the Gleason Score is nothing by the tip of the iceberg:
I too, upon diagnosis was barely a 3+4=7. I only had 6-10% of "4" rated cells in my biopsy. I was more 3+3=6, but those 6-10% of "4" cells made me the 3+4=7. My urologist is totally against Active Surveillance. He flat-out said: "YOU HAVE CANCER...there is no point doing Active Surveillance for two years, because all you are doing is giving the cancer time to grow. So...I'm taking your prostate (he insisted on surgery)." And HERE is the kicker: Your Gleason Score says NOTHING about the extent of, and cellular pathology of, your prostate cancer. My urologist was overly confident saying "don't worry, we've caught this really early, so you'll be around (alive) for the next 15 years or more (I am 70 years old)." Then the post-surgical pathology report came out. I had Extraprostatic Extension (EPE) where the tumor broke through the membranous capsule of the prostate. NOT GOOD. I had "surgical margins" meaning that there was enough tissue outside the prostate capsule due to EPE, that my urologist couldn't remove it all. NOT GOOD. I had left seminal vesicle invasion. REALLY NOT GOOD. I had Cribriform glands (prostate tissue looks like Swiss cheese with holes in it on the microscope slide). REALLY NOT GOOD. ALL of this was not known from the biopsy and resulting Gleason Score. All of that microscopic, cellular pathology put me into the pT3b category. Even though both of my seminal vesicles were removed, along with my two vas deferens, and the prostate itself, I still have cancerous prostate tissue left in me...and it will grow. The nature of the seminal vesicle invasion, means that the cancer has a 25-50% chance of recurring "within" five years of the radical prostatectomy. My doctor was silent and shocked, saying: "it seems that your cancer was more advanced and aggressive than I thought." The overly confident attitude was now much more solemn. My first two PSA tests at 3- and 6-months post-op were fine at < 0.1ng/ml, but I have been referred to a Radiation Oncologist. I met with him, and he said that I wasn't ready "yet" for radiation, but will likely need it. He ordered an "ultra-sensitive PSA" that I will have done this week in timing with my 9-month post-op regular PSA. The radiation oncologist wants to see at least two data points for ultra-sensitive PSA before he decides "when"/"if" I get radiation. He has also been very candid about the great likelihood of lifelong urinary incontinence. I can't handle that...I literally can't handle that. I am just now, finally at 98-99% urinary continence at 9 months post-op. I still have accidents - quick leaks/dribbles - that see me wear a thin Depends Shield, but I hate it. I absolutely am enraged by urinary incontinence and a dead penis. I haven't had an erection in these 9-months post-op, when prior to that at early age 70, I had the virility and "performance" of a 35 year old. The message is quite clear: radiation oncology is NOT a perfected treatment modality. It is still so bad, that they tell you what the negative outcomes of doing it are. They can't seem to fine-focus the radiation beam to the bed of the prostate where the cancer still is, to treat just that area, without frying your urethra and bladder, and potentially your rectum. No thanks. And of course, this blog here is full of men who discuss that their cancer is back 1, or 3, or 5, or even 10 years after radiation therapy. So...radiation therapy doesn't work all of the time. It just delays the inevitable return of the cancer. They really just play the odds. They know it is a slow growing cancer, and that the various treatments (surgery, radiation, ADT/hormonal treatment, etc.) just slow the progression. They know it will come back, but they lie or fool us into thinking we are cured after each phase of treatment. So...long story short: Have the radical prostatectomy NOW, and just hope that your cancer is not as bad as it might potentially be like mine was with the seemingly innocuous "low-moderate risk" Gleason of 3+4=7. And... make sure that your physician orders the Decipher Test on your prostate biopsy or surgical tissue. It is a proprietary genetic test to screen for 22 prostate-specific cancer genes. It is scored 0.1 to 1.0. You want the lowest score possible. The results and what genes you have, offer a stratified, comparative risk assessment for your cancer, and your estimated longevity at 5, 10, and 15 years. The test is only performed by the lab who developed the test: Veracyte Labs in San Diego, CA. Insurance and Medicare cover the test...don't let anyone tell you that it isn't covered. Good luck. Keep us posted with a retrospective intro before your update each posting.

I agree, 3+4 is very treatable without horrible side effects, especially if some form of radiation like SBRT is used. The OP should not ignore this situation, but rather do some treatment with the least side effects possible and likely enjoy a long remission. See my bio for more details.