My Gleason score is 7 - 3+4. How long can I live without treatment?

Posted by mayoclinicadvice23 @mayoclinicadvice23, Jun 11, 2023

My Gleason score is 7 - 3+4,. How long can I live without treatment? Since I decided not to get any treatment, because of horrible side effects, I was wondering, if someone who experienced the same condition, will share his experience with me.

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A few recommendations. 1. Review videos from Prostate Cancer Research Institute on Gleason 7.
2. PSA each 6 months
3. Have an oncologist you trust and collaborate on your care.
4. Each person's Cancer is unique. General information is helpful but you really need good medical advice specific to you.

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Hi!

I had the IRE done at Moffitt Cancer Center in Tampa Florida. Dr. Julio Pow-Sang was my surgeon. I have been very impressed with the doctors, staff and facilities at Moffitt.

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@milburnd

Like you, my Gleason was a 3+4=7. I had two tumors that were contained in the prostate, though one of them abutted the edge. I also had a Decipher test of my biopsy tissue which showed low risk. Also like you, I was reluctant to consider removal or radiation due to the potential side effects. Being concerned that one of the tumors was abutting the edge of the prostate, I looked into focal treatments rather than active surveillance. The focal treatments attempt to kill the tumor(s) by freezing, by heating or by electricity, with supposedly less risk of side effects. I opted for Irreversible Electroporation (IRE), which uses electricity to zap the tumors. I had that treatment 10 days ago, so it is too soon to know the result or side effects, but I am optimistic. I think the doctor for @jonheli is spot on in saying the doctor and the hospital are key to a good outcome. My very good treatment was at a medical facility that is a National Cancer Institute Comprehensive Cancer Center of Excellence. You can find the Institute's list of centers of excellence at this website: https://www.cancer.gov/research/infrastructure/cancer-centers/find

Good luck!

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Hi:

Where is Irreversible Electroporation (IRE) done? Never heard of this one.

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I too had 3+4 and Decipher test. I had 5 narrow margin linac radiation treatments in Jan/Feb 2023. I did not want to take the risk of spreading and dealing with the potential side effects of all the treatment and medications. There are no guaranties or predictions that it would not spread even if I was actively monitoring it every 1-3 months with a blood test. I did not want to ever have to say...I wish I had treated it when I had the chance.

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I also had the 3+4 score when discovered in early 2017. At the time my Oncologist offered three or four options, one being do nothing. His prognosis if I choose that, was about 6 years. Fout without little change but then maybe a couple of miserable years.
As I had tended to my Dad during his last year with untreated prostate cancer, I wanted no part of that and accepted treatment.
Good luck and God Bless.

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I can't get past your "horrible side effects". I am 18 days post SBRT and on day 41 of Orgovyx and as of yet have not experienced anything other than mild side effects.

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Like you, my Gleason was a 3+4=7. I had two tumors that were contained in the prostate, though one of them abutted the edge. I also had a Decipher test of my biopsy tissue which showed low risk. Also like you, I was reluctant to consider removal or radiation due to the potential side effects. Being concerned that one of the tumors was abutting the edge of the prostate, I looked into focal treatments rather than active surveillance. The focal treatments attempt to kill the tumor(s) by freezing, by heating or by electricity, with supposedly less risk of side effects. I opted for Irreversible Electroporation (IRE), which uses electricity to zap the tumors. I had that treatment 10 days ago, so it is too soon to know the result or side effects, but I am optimistic. I think the doctor for @jonheli is spot on in saying the doctor and the hospital are key to a good outcome. My very good treatment was at a medical facility that is a National Cancer Institute Comprehensive Cancer Center of Excellence. You can find the Institute's list of centers of excellence at this website: https://www.cancer.gov/research/infrastructure/cancer-centers/find

Good luck!

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I was diagnosed with prostate cancer in 2009, at age 49.
Gleason 7 (3 + 4), tumors on both sides of prostate, but still confined to prostate.
I opted for full open surgery at Sloan Kettering.
I’ve been PSA 0 since surgery 15 years ago. The side effects from surgery have been real, but far from “horrible.” I did not become incontinent, but when I need to go to the bathroom, I have less time than I had before the surgery. I’ve been able to make some behavioral changes to overcome this — such as going to the bathroom before going somewhere where I won’t have access to one. Simple solution— works all the time!
Re:sex, after the surgery, I couldn’t get a good enough erection for sex unless I took viagra. It’s still that way for me.
But, with viagra, I can have sex.
Problem is that viagra gives me a headache.
Also, Viagra works best for me when I first wake up. And I’ve learned not to take more than I need.
So, sex life was hindered by the surgery, but, with an understanding wife, we were able to at still have sex, though less spontaneously.
Seems like a small price to pay for substantially reducing cancer risk!!
As for all of the different treatment options, I still remember the advice of my surgeon, Dr Scardino, who was the head of the Prostate Cancer dept at Sloan Kettering at the time.
His advice was that the quality of the Dr and hospital providing treatment is a large factor in its success, regardless of the type a treatment you choose. Yes, learn about the treatment options available, but don’t forget to put great weight on the quality of the provider.
Good luck, don’t stress out, and live you life!

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I was diagnosed stage 1, intermediate 4+3/7. I had one core genetically test for aggressiveness and just being over the line to bad, I was ruled out for surgery, brachytherapy. That left high/low dose radiation. I decided on proton hdr, with SpaceOar Gel and hormone treatments. I finished a month ago and am doing well. The shots were a bitch but only received 3, two Firmagon one Eligard. My high dose treatments were 5 sessions. I follow up in August. Side effects are diarrhea, ED and dry orgasms. I could have took the wait and see, however my surgeon and oncologist both said to treat instead of not and wondering. I’m hoping my side effects will subside as the drugs work their way out. I wish you well. Get Walshes book, Surviving prostate cancer and read it, it will help and lays out all your options.

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@tonytiger

I was 48 when I was diagnosed with Prostate Cancer. I was Gleason grade 7 (3+4). I had robotic surgery to remove the gland. Now I am 64. I decided after surgery that if cancer returned, I would not seek any further treatment. I was followed by my Urologist after surgery and watched as my PSA slowly climbed from 0.03 to 1.5 within a few years. My Urologist recommended salvage radiation. I moved to another state for work and didn't find a new Urologist for follow up. I had my primary care physician order PSA tests instead and I tracked the results myself. I was very happy with my decision for the last 12 years. No treatment and no side effects. Last summer my PSA went from 4.0 to 7.0 and my doctor urged me to see a Urologist again. I didn't want further treatment if it was not going to lead to a cure. It seems that now with new therapies available it might be worth looking into my options again.

I had a PSMA pet scan that did not show cancer, but there was an undefined spot in the bladder. A biopsy confirmed that there was a lesion (Gleason 9 4+5). My Urologist has hopeful that with a treatment plan that included IMRT and ADT plus a second-generation Hormone agent there was still a high likelihood of a cure. So, I decided to give it another shot.

I don't believe you are wrong to want to avoid any treatment. I almost made that decision myself. I am hopeful that I could be cured, and I chose to take a risk because the side effects from cancer not being treated are worse. I think if you decided not to seek treatment you would have 15-20 years of survival, but who knows. It depends on a lot of things like your age, how large is the tumor and any other health conditions you may have.

Today there are so many more treatment options that it can all be overwhelming. I would recommend that you start with "active surveillance." This approach allows you to keep an eye on your cancer and decide on a treatment when you are ready for that next step. You can research focal therapies that target the tumor but spare the surrounding structures. You may be a candidate for SBRT (a shorter course of radiation) or Brachytherapy (radioactive seeds implanted permanently or temporarily) or other types of focal therapies. Talk to your doctor. Seek a second opinion. There are many sources of information online that can guide you in your search.

I am attaching a video I hope it is helpful.

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A lot depends on your age. I was 73 this year when my 4-3 was found. If I get 16 years like you before it comes back I will be 89 and more than likely dead from something other than PC.

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