Has Anyone Elected for No Treatment?

There is no easy answer to this. If you have a Gleason score of 3+3, then you can probably go on active surveillance. If it’s higher than that, then you probably need treatment and if you don’t get it, your progression free survival is limited. How much it is limited is based on where your cancer started in strength and location in your body. If you get no treatment, you have no idea what’s going on.

Dying from prostate cancer is extremely painful. My father had his teeth ground down and crowned without Novacaine. He came home for dinner every night, and you’d never know it. He was on so much morphine a few weeks before he died of prostate cancer,that he couldn’t communicate at all.

Are you prepared to live like that?

Hi Jeff, thank you for your advice. I appreciate it a ton. I was wondering if you had seen my first post called "Worried and Looking for Advice"? Would you mind reading that post and let me know if you think Im over worrying at this stage?

Yes, dying from any cancer is often painful.

Last October, my older brother (74y) died of pancreatic cancer. It was not a good death. (I was there much of the time.) He was on morphine for some time towards the end.

Just last night, my daughter-in-law's sister (49y) died of Leptomeningeal cancer. It was not a good death. She was on something stronger than morphine for the past week.

I assume that it’s the same with prostate cancer. Something to avoid (and seek treatment) if possible.

I was diagnosed with PCa in April 2012 at 56y with a localized, 3+3=6, PSA of 4.2, and chose active surveillance.

I made a commitment that should my PSA ever reach 10, or my Gleason ever reach 7, or a biomarker (genomic) test ever have a negative result, that I would then seek active treatment.

I was on active surveillance for about 9 years, not only tracking PSA every 4-6 months, but also getting biopsies every 2-1/4 years, regularly calculating the lesser-tracked numbers (% Free PSA, PSA Doubling Time, and PSA Density), and getting a genetic (germline) test, all to have better insight into what might be lurking unseen.

Eventually, my Gleason did hit 7 and a biomarker test indicated that I had “exceeded the threshold for active surveillance.” (My PSA never exceeded 8.05.)

It was then that I started active treatment (in April 2021). Treatments were uneventful and today I’m doing great.

These days, it’s realized that even a 7(3+4) with a very high % of “3” and no other risk factors might also be a candidate for active surveillance. So, the decision on whether to choose and stay on active surveillance depends on your specific numbers and other risk factors.

Good luck!

Diagnosed in October 2023, after PSA of 7.8 PSA & 3, 4 & 5 PIRAD lesions found in an initial mpMRI.

Targeted TRUS found 7/15 cores positive…five 3+3 (5-10%) & two 3+4 (10-20%).

My Decipher score was 0.22 and the GRID report's Clinical-Genomic Model indicated “Low Risk" and recommended active surveillance, to which my urologist agreed.

Increased my running regiment to three 5K’s/wk, along with occasional HIIT, and implemented a whole plant food diet for the first three months to lose 25 lbs and reach a BMI=22.5 by Feb ‘24. At that point, I changed over to what is probably best described as a "heart healthy" diet and have maintained the lower weight/BMI ever since.

My PSA dropped 25% after 4 mths and has stayed at the new (lower) level for the last 18 months. My most recent PSA was at it's lowest since pre biopsy, at 5.6.

A 12 month follow-up MRI, compared by the same radiologist, indicated that the original PIRADS 3 and 4 lesions were no longer visible and the PIRADS 5 had shrunk and its T2 & DWI/ADC signals were reduced from “moderate” to “mild”.

Since March 2025, I modified my running regiment to maintain my long distance running in "Zone 2"....I always run on local track and use Hoka Bondi 8's (extra cushioning) to ensure joint safety.

My general health (other than PCa) has improved significantly, as other chronic issues have disappeared.

Overall, I'm convinced the aerobic cardiovascular exercise has been the key driver to my success (see ERASE randomized clinical trial results).

Disclaimer: I'm not a physician and your results may vary.......