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Gleason7(3+4) - treatment options recommendation

Posted by manojsmishra @manojsmishra, Aug 25, 2024

Got recently diagnosed with Gleason group 2, 7(3+4). Was in state of shock to know about the cancer.
I’m 56 year old and fortunately I’m with Mayo care since last decade.
Recommendation for me is to have prostatectomy as radiation therapy has long term implications. Took outside opinion also and same recommendation. But not sure how to deal post procedure with urge to urinate situation currently there.
Biggest thing is I’m hoping there is no recurrence occurring after this. Any suggestion/recommendation?

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jc76 | @jc76 | 5 days ago
In reply to @johnnyz "@jc76 Hello and Happy Monday - I have not had conversation about a decipher test or..." + (show)
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@jc76 Hello and Happy Monday - I have not had conversation about a decipher test or genome test. I have asked but they brush it off. Now that I have detailed consultations with an RO (appointment is being scheduled today), and Robotics Surgeon Sept. 24, I will push these topics for additional testing. Even the need for a PSMA PET scan as I have a bit of worry around if the fact that they found evidence of cribriform and it's know for micro matastasis ...

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@johnnyz
Yes both tests (I had both) will provide you and your doctors information in deciding your treatment plans.

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Jeff Marchi | @jeffmarc | 5 days ago
In reply to @pesquallie "@rlpostrp More than 50% of men do not recover from ADT and if you are over..." + (show)
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@rlpostrp

More than 50% of men do not recover from ADT and if you are over 80 you likely will never recover and you will have side effects for ever. Recent data indicates that testosterone does not feed cancer and low testosterone may actually increase cancer. I am 84 and my urologist who said no Testosterone Replacement Treatment 6 months ago now has me on TRT and my Lupron side effects have disappeared within a week and I just started having some libido and erections.

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@pesquallie
You are quoting loose and fast with numbers you cannot justify with statistics.

From the PCa commentary

Examples of the relationship of the duration of ADT exposure to subsequent recovery to their
original T levels after stopping ADT are as follows:
- After 3 - 9 months of ADT nearly all men fully recover by about 10 months;
- After 18 - 24 months of ADT only 60% fully recover by about 3 years; and
- After 36 months of ADT exposure only 50% fully recover by ~ 5 years.
It is clear that after receiving ADT for longer than 6-9 months many men never fully return to their
T baseline. This raises the very important question of whether it is safe to offer replacement
testosterone in symptomatic men who have been rendered persistently hypogonadal (<230
ng/dL).

As it shows here whether or not you recover, depends on how long you’ve been on it. Only in the longest cases Do 50% not recover their testosterone. With 3 to 9 months of hormone therapy virtually all of the men return to their previous testosterone levels.

When somebody is first diagnosed with prostate cancer, hormone therapy drops their PSA immediately, and it stops the cells from growing and spread spreading. That is a fact and has been repeated over and over.

Only when somebody becomes castrate resistant does dropping of the hormone therapy help because resistance cells can’t handle testosterone at that point, though not all cells are resistant so some of them would still be suppressed.

You make it sound so simple and it’s actually very complex.

I would like to see your statistics to back up what you were saying.

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pesquallie | @pesquallie | 5 days ago
In reply to @jeffmarc "@pesquallie You are quoting loose and fast with numbers you cannot justify with statistics. From the..." + (show)
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@pesquallie
You are quoting loose and fast with numbers you cannot justify with statistics.

From the PCa commentary

Examples of the relationship of the duration of ADT exposure to subsequent recovery to their
original T levels after stopping ADT are as follows:
- After 3 - 9 months of ADT nearly all men fully recover by about 10 months;
- After 18 - 24 months of ADT only 60% fully recover by about 3 years; and
- After 36 months of ADT exposure only 50% fully recover by ~ 5 years.
It is clear that after receiving ADT for longer than 6-9 months many men never fully return to their
T baseline. This raises the very important question of whether it is safe to offer replacement
testosterone in symptomatic men who have been rendered persistently hypogonadal (<230
ng/dL).

As it shows here whether or not you recover, depends on how long you’ve been on it. Only in the longest cases Do 50% not recover their testosterone. With 3 to 9 months of hormone therapy virtually all of the men return to their previous testosterone levels.

When somebody is first diagnosed with prostate cancer, hormone therapy drops their PSA immediately, and it stops the cells from growing and spread spreading. That is a fact and has been repeated over and over.

Only when somebody becomes castrate resistant does dropping of the hormone therapy help because resistance cells can’t handle testosterone at that point, though not all cells are resistant so some of them would still be suppressed.

You make it sound so simple and it’s actually very complex.

I would like to see your statistics to back up what you were saying.

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@jeffmarc
There are many recent studies that show that low testosterone can be a problem. I could not get the web sites to copy properly so you might have to Google the titles to see the articles. Following are a few:

"Testosterone Supplementation After Prostate Cancer Treatment
YouTube - ISSM International Society for Sexual Medicine" - Dr. Mohit Khera (Baylor College of Medicine) and Dr. Gerald Brock (Western U. London) explain the evolving view on testosterone and prostate cancer, noting a shift from seeing testosterone as harmful to recognizing potential therapeutic or preventive roles. Low testosterone is linked to higher risk of high-grade cancer, recurrence, and poorer erectile recovery. 3/28/25

"Testosterone replacement therapy following definitive treatment for prostate cancer: a scoping review of safety and efficacy | International Journal of Impotence Research"
Conclusion: TRT does not increase the advancement of prostate cancer and may actually decrease cancer growth. 11/26/25 summary of 12 studies.

"Testosterone and prostate cancer: What's the connection? - Mayo Clinic"
Conclusion: Studies have shown that testosterone replacement therapy doesn't seem to increase the risk of prostate cancer returning. 10/29/25

"Study Solves Testosterone’s Paradoxical Effects in Prostate Cancer" | Duke Health

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prostatssuck | @prostatssuck | 20 hours ago
In reply to @prostatssuck "On February 8th 2024 I was diagnosed with Gleason 4 + 5 equals nine and a..." + (show)
Profile picture for prostatssuck @prostatssuck

On February 8th 2024 I was diagnosed with Gleason 4 + 5 equals nine and a PSA of 79. The cancer had spread through my spine my ribs and my hips.
I'm not a doctor nor do I play one on TV but here's what I did.
I got a shot of lupron and added 140 mg of Xtandi daily.

Then I worked on my attitude: victory over cancer is a decision not a happening. Got on as many prayer chains as people were willing to send me positive thoughts and prayers.

Then I looked at my diet. I immediately dropped all white sugar, white flour and processed food like bacon, sausage, lunch meat etc from my diet. I also dropped red meat mostly, one red meat a week and switched to chicken and turkey as well as green leafy vegetables and lots of broccoli. I drink coffee black, green tea, Gatorade zero, and lots of V8. And instead of bottled water I now drink alkaline spring water with a pH of 8.1 because my research indicated that prostate cancer cells hate the near acidic environment of the body.

Then I started with these supplements:
Two capsules of reishi mushrooms a day (research them)
3000 mg of turmeric garlic and ginger that's two capsules a day (you can find them combined in capsule form on Amazon)
Next was 10,000 mg of vitamin C, yes 10,000 mg.

Then, while doing that, I had five treatments of targeted radiation at the metastasized cancer cells.

I hurt a bit because any cancer that escaped the prostate caused damage to the nerves in the areas above and so I used ultra high frequency radio ablation to deaden the damaged nerve endings. My pain went from about five or six to about one or two on the scale of 1 to 10.

No surgery, no chemo.

On July 12th 2024 my PSA score was 0.0 (see image below).

My Xtandi has been dropped to 80mg daily and I see my ooncologist again in October.

My goal is to beat this thing, keep it down, and educate other people about how I handled it.

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@prostatssuck

It is now August 2026 and I am in complete remission still following what I outlined above.
Psalm 8
Psalm 56
Psalm 91

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