@thefonz Regarding your downgraded Gleason score.

A Gleason score is a pathologist’s educated, experienced, and expert “opinion” of what he (or she) believes they see under a microscope); it’s often as much an art as it is a science.

What one pathologist sees as a Gleason 7(3+4), another might see as a 7(4+3), and another as a 7(3+5). There’s no sure way to know which one is “right.”

When I was diagnosed with a 7(3+4) and waiting for the results of a 2nd opinion, (and understanding the ambiguity about the situation), I made a personal commitment:
> if the 2nd opinion came back a lower 6(3+3), I would still get treated to the original higher 7(3+4);
> if the 2nd opinion came back the same 7(3+4), I would (of course) get treated to that 7(3+4);
> if the 2nd opinion came back a 7(4+3), I would then get treated to the higher 7(4+3).

As it turned out the 2nd opinion came back a higher 7(4+3), so we added 30 days of Bicalutamide (Casodex) and 6 months (two 3-month injections) of Eligard. (My doctor even asked if I wanted another biopsy as a tie-breaker; I said “no, let’s go with the 4+3.”)

What I didn’t want to do was to inadvertently under-treat the disease and then have to address it again later. (Nor did I want to turn my prostate into a pincushion with another biopsy.) Time will tell if that was the right call, but so far, so good (5+ years later).

These are all personal calls that one has to make as part of self-advocacy and shared decision-making. (And it might be why they chose to go with hormone therapy for your 3+4=7.)

@thefonz
The other aggressive issues are

any of these things found in the biopsy intraductal, ductal, large cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive.

The Gleason score does not take into account these issues.