My biopsy gleason score was also 3+4 from local lab. Sent the slides to John Hopkins, they confirmed the 3+4 and said no cribriform noted. I then sent sample for a prolaris genomic test. It came back that I was on the borderline of active surveylance or treat. I too was worried about over treating a low grade cancer. The 5 SBRT treatments seemed like the way to go but I was afraid it would make my existing urinary issues worse. I opted for surgery and am glad I did. My post surgery pathology ended up being 4+3 with a small amount of 5 and there was cribriform morphology. My biopsy missed higher grade cancer the 4 portion of my 3+4 grew from the time of biopsy to the time of surgery, May to Sept. I kinda doubt that. The biopsy is just a small sample of the overall prostate so I believe it just missed some cancer. On the other hand, gleason scores are sometimes downgraded after surgery. If I was 3+3 I would have just watched it but having the 4 was the deciding factor for me. Each case is unique tho. I'm happy with my decision.