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

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!

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!

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.

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.

I have nothing to add to the above comments, However I would just like to say THANK YOU to everyone out there for sharing their stories. It has given me some confidence in my decision to have surgery first and then have radiation later on, if necessary. I have surgery next month for regional metastatic PC. I have been doing my pelvic floor work everyday for a month . And hoping for the best.

Why gamble, get something done and if I had a radical prosectomy and five years later had to go back for a series of radiation treatments for a small spot where the prostate connects to the back of the body. Knowing what I know now, I would get radiation treatments, they have come a long way. It's scientifically done with precision accuracy and doubt that there is any side effect. At least I had none on the follow up radiation. Consult the Keiser Institute of the Beaufort Memorial Hospital to find out exactly what machine they use and then ask about the possible of side effects and the probability of them happening, Worry will kill you faster than prostate cancer.

I had 3+4 and 4+3 Gleasons. I also had a PSMA scan which showed the cancer was confined to the Prostate. One of my doctors ( I gathered so much information my head began to swim.) stated that radiation after a Prostatectomy is viable, but surgery after radiation is not as good/viable due to the effects of radiation on one’s body. For this and my other data gathered, plus reading Dr Patrick Walsh’s book on Surviving Prostate Cancer, I opted for the RALP. I did Pelvic Floor PT prior to and after surgery, guided by a woman, at a Baylor, Scott & White clinic in Austin, who was educated and trained to help men with Prostate Cancer. I had ZERO continence issues, NONE! The pathologist who examined my removed prostate stated the gland contained a cancer that WOULD HAVE SURVIVED radiation. By the way, after reviewing my documents and my thoughts, I told my Urologist I wanted the surgery. He said that, if it were him with my numbers, he would have made the same choice. (What a relief!) So, whatever path you choose, I sincerely wish you all the best!

I was also diagnosed with Gleason 3+4. MRI showed tumor contained within prostate gland. Post operative biopsy told a different story as the PC had grown through outside of the prostate ( extraprostatic extension) on the microscopic level. Doctor said 70% chance of recurrence. Remember the original biopsy only takes a few samples and it's not uncommon for Gleason scored to be raised after surgical biopsy. ( they could also be lower) As far as longevity, there's no Crystal ball with PC. Even if one lives many years before dying from PC, I can only imagine the last few years would not be pleasant. I personally would not ignore your Gleason 4. I wish you well.

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.

@ozelli, I noticed that you wished to post a URL to an article with your post. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe. Clearly the link you wanted to post is not spam. Please allow me to post it for you.

- Prediction of metastatic prostate cancer by prostate-specific antigen in combination with T stage and Gleason Grade: Nationwide, population-based register study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988964/