To all who keep seeing my same post: my apology, but...with each newly diagnosed person who has joined this blog, I must say:
The Gleason Score is only the "tip of the iceberg"...what could be and usually is, a huge iceberg of unknown pathology lurking under the waters unseen, until you have the radical prostatectomy. I too was a Gleason 3 + 4 = 7 with only 6-10% of cells being classified "4". I had 3 negative/normal cores, 3 cores 3 + 3 = 6, and 6 cores 3 + 4 =7. My urologist was confident ("we caught this early."), but still insisted on the radical prostatectomy. He does not believe in "Active Surveillance" ("You HAVE cancer, it is not going away, and why give it two years to get worse?"). So...I am glad I had the radical prostatectomy because...
I had all kinds of additional pathology that a biopsy and Gleason Score can't reveal. It threw me from what was thought to be a T1, or at worst a T2, class cancer, to a pT3b cancer because I had Extraprostatic Extension (the tumor broke through the membranous capsule that surround the prostate). With that, all bets are off. Thus, I had "surgical margins" showing that the tumor extended beyond what the urologist removed from me. In other words, he left cancer cells in me. And...the pT3b means that the cancer invaded one or both seminal vesicles because it broke out of the capsule. I had left seminal vesicle invasion...fortunately without tumor or nodules - just cells at that point. I also had Cribriform glands tissue...another ominous sign.
What I am getting at, is that the Gleason Score just tells you that have, or don't have, cancer, and if you do, the cellular characteristics allow a classification. But...it says nothing of what is going on anatomically with the growth and spread of the tumor. My advice is to have the radical prostatectomy AND make sure that you get the Decipher Test. It is a proprietary test developed and performed only by Veracyte Labs in San Diego, CA. It is a test that screens for 22 known prostate-specific genes, and it yields a test result "score" of 0.1 - 1.0. You want a low score showing you don't have any of the genes, or if you have them, they aren't the worst genes. The closer you are to the 1.0, the more genes you have, and which are the worse genes to have. The score yields a risk-stratified prediction of metastasis and your mortality (longevity) at 5 years, 10 years, and 15 years with standard therapy and treatment. Make sure your urologist sends some of your biopsy or post-surgical tissue to Veracyte Labs for that test. Bottom line: Like me, you can have a seemingly low-moderate risk cancer based on the Gleason Score, when in reality, your cancer can be more aggressive and far worse. Good luck to you.