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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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heavyphil | @heavyphil | Feb 4 6:23am
In reply to @graybeard46 "I asked this question after I had surgery, Dr can’t really give you a good answer,..." + (show)
@graybeard46

I asked this question after I had surgery, Dr can’t really give you a good answer, how old are you ? I ask myself this question but it’s too late surgery missed getting it all now into radiation, asked my radiologist that question last week but now my cancer more active than originally know so he said maybe 5 yrs as a guess, good luck if you about 70 it’s a gamble on your part, good luck

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No one has a crystal ball. 5 yrs, 10 yrs, it’s all guesswork. Really surprised your doctor put ANY time frame on your possible lifespan. You are currently in salvage radiation with ADT - far, far, FAR from being anywhere near dead from PCa!!
There are guys on this board who got this disease in their 50’s and early 60’s who are still here in their 80’s so where’s this 5 yr BS coming from??
It’s cold and bleak in the Boston area this time of year, but in about 2 months things will start to green up, you’ll be done with radiation and you’ll feel a lot better about things. Just give it time…
Phil

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joecontheroad | @joecontheroad | Feb 4 5:19am
In reply to @heavyphil "Sounds like you have a plan. Didn’t know you had a short life expectancy so perhaps..." + (show)
@heavyphil

Sounds like you have a plan. Didn’t know you had a short life expectancy so perhaps this non- treatment works best for you.
Phil

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Just to clarify: not "short life expectancy", but "acceptably good more years left". After those 5 years, at then 83 years old, I expect -- though of course hope I'm wrong! -- my current lifestyle will have to change for reasons other than PCa.

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graybeard46 | @graybeard46 | Feb 3 11:19am

I asked this question after I had surgery, Dr can’t really give you a good answer, how old are you ? I ask myself this question but it’s too late surgery missed getting it all now into radiation, asked my radiologist that question last week but now my cancer more active than originally know so he said maybe 5 yrs as a guess, good luck if you about 70 it’s a gamble on your part, good luck

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1 reply
pieperfarm | @pieperfarm | Feb 3 8:42am

I was confirmed to have Gleason 6 in 2017, and Gleason 7 in 2023. I had a HIFU procedure with no side effects to eliminate all of the Gleason 6 and Gleason 7 in 2024 on one side of the prostate. I still have Gleason 6 on the other side of the prostate. I am 58.

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1 reply
heavyphil | @heavyphil | Feb 3 7:06am
In reply to @joecontheroad "The "just had" is not comforting: it's the sometime after just had that I am concerned..." + (show)
@joecontheroad

The "just had" is not comforting: it's the sometime after just had that I am concerned about and what prevents my doing it. BTW: that "rise", for now at least, is only to 0.08 (from < 0.05, but psa's from two different labs, and the newer one is not known to me as wholly reliable) while off of ADT for 9(?) months. And, it seems to me, I don't likely have more than five acceptably good more years left anyway, and if going back on ADT keeps things in check for those years... 😉

I've provided this link in response to a post elsewhere. It was published after I had made my decisions, so it *maybe* has confirmed my decisions rather than having influenced them:
https://www.urotoday.com/video-lectures/localized-prostate-cancer/video/4525-overtreatment-of-prostate-cancer-persists-in-men-with-limited-life-expectancy-timothy-daskivich.html

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Sounds like you have a plan. Didn’t know you had a short life expectancy so perhaps this non- treatment works best for you.
Phil

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1 reply
joecontheroad | @joecontheroad | Feb 3 6:20am
In reply to @heavyphil "Can I ask why no radiation? I just had 25 rounds at Sloan and it was..." + (show)
@heavyphil

Can I ask why no radiation? I just had 25 rounds at Sloan and it was nothing. The worst ( if I can even call it that!) part is figuring out the bladder and bowel prep. Side effects minimal.
Sure, maybe years out they will develop, but I might not have gotten those years without the treatment.
Being on ADT for the rest of your life - which rising PSA indicates- can possibly be even more hazardous to your health.
Not criticizing or judging your personal decisions. Mine are different, that’s all. You’ve really been quite fortunate to go 20 yrs without treatment and no one can deny that the gamble you took really paid off.
Best of luck on whatever you decide!
Phil

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The "just had" is not comforting: it's the sometime after just had that I am concerned about and what prevents my doing it. BTW: that "rise", for now at least, is only to 0.08 (from < 0.05, but psa's from two different labs, and the newer one is not known to me as wholly reliable) while off of ADT for 9(?) months. And, it seems to me, I don't likely have more than five acceptably good more years left anyway, and if going back on ADT keeps things in check for those years... 😉

I've provided this link in response to a post elsewhere. It was published after I had made my decisions, so it *maybe* has confirmed my decisions rather than having influenced them:
https://www.urotoday.com/video-lectures/localized-prostate-cancer/video/4525-overtreatment-of-prostate-cancer-persists-in-men-with-limited-life-expectancy-timothy-daskivich.html

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1 reply
russ777 | @russ777 | Feb 2 7:59pm
In reply to @chippydoo "Thank you and wish I had this prior to starting short term Lupron for 6 months...." + (show)
@chippydoo

Thank you and wish I had this prior to starting short term Lupron for 6 months. Going to ask if I can switch at my 3 month appointment and shot. Frankly I am at the point of switching Doctors. Every week something else like this pops up. Best wishes.

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I don't think that is uncommon - (every week something else pops up.)

Might mention that if you download the Supplementary Appendix from the link provided in the paper there is a lot of other detailed comparison data. FYI.

Best of luck!

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chippydoo | @chippydoo | Feb 2 6:48pm
In reply to @russ777 "I don't think it's accurate to conclude only if you are on long term ADT do..." + (show)
@russ777

I don't think it's accurate to conclude only if you are on long term ADT do you risk having CV events. That may or may not be true of blood glucose issues. The image here is from the reporting on the HERO trial which was the Phase 3 randomized clinical trial comparing relugolix (aka Orgovix) to lupron. It shows % of each arm that experienced a MACE event (Major Adverse Cardiac Events) as a function of time under treatment - 0-48 weeks.

What you see is that MACE events occur at a more or less constant rate (the graphs approximate straight lines). That rate does not increase with time. The graph increases with time because it is counting cumulative events. To me that says at any arbitrary point in time under treatment with either medication, there is a constant probability of a MACE occurring. It stands to reason, though I don't think it is proven in this trial, that those experiencing MACE events early would be those patients with the most advanced CV issues going into treatment. Link to the HERO trial:
https://www.nejm.org/doi/full/10.1056/NEJMoa2004325
Figure 2, Cumulative incidence of MACE:

Jump to this post

Thank you and wish I had this prior to starting short term Lupron for 6 months. Going to ask if I can switch at my 3 month appointment and shot. Frankly I am at the point of switching Doctors. Every week something else like this pops up. Best wishes.

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1 reply
russ777 | @russ777 | Feb 2 3:25pm

One more try with the image...
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russ777 | @russ777 | Feb 2 3:20pm
In reply to @chippydoo "Long term rather than short term ADT? It is my understanding that long term ADT can..." + (show)
@chippydoo

Long term rather than short term ADT? It is my understanding that long term ADT can affect the heart, lipids and bring on diabetes. Short term doesn't have these affects from what my provider told me. Actually, told me to be as active as I can tolerate and officiate spring sports season. I will see about that after I finish 25 radiation sessions.

Jump to this post

I don't think it's accurate to conclude only if you are on long term ADT do you risk having CV events. That may or may not be true of blood glucose issues. The image here is from the reporting on the HERO trial which was the Phase 3 randomized clinical trial comparing relugolix (aka Orgovix) to lupron. It shows % of each arm that experienced a MACE event (Major Adverse Cardiac Events) as a function of time under treatment - 0-48 weeks.

What you see is that MACE events occur at a more or less constant rate (the graphs approximate straight lines). That rate does not increase with time. The graph increases with time because it is counting cumulative events. To me that says at any arbitrary point in time under treatment with either medication, there is a constant probability of a MACE occurring. It stands to reason, though I don't think it is proven in this trial, that those experiencing MACE events early would be those patients with the most advanced CV issues going into treatment. Link to the HERO trial:
https://www.nejm.org/doi/full/10.1056/NEJMoa2004325
Figure 2, Cumulative incidence of MACE:
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