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

Hey Bud, it’s ONE opinion, OK? Just because someone says that you “could” live 10-15 yrs, doesn’t mean you will. I read similar articles years ago when I was diagnosed at age 64. I did the math and said “nah” and had surgery because #1. - I was young-ish and #2 because it was higher risk Gleason 7 and could come back (it did).
In your case at age 78, I personally would have leaned more toward radiation (again, doing the math), but with a PSA of .36 right after surgery, you must have had metastasis somewhere that didn’t show up on a PET scan ( assuming you had one!).
So even if you chose radiation you still might be in the same situation - with perhaps even less treatment choices - just a life of continual hormones and drugs even worse, as far as sex is concerned.
As far as having NO treatment goes, I don’t think even the most open-minded progressive oncologist today would tell you to do nothing; many men live into their 90’s and who wants to play Russian Roulette with cancer??
What would you have said if 2 or 3 yrs from now, with no treatment, a doctor told you that you were gonna die because you had prostate cancer in your liver or wherever….it DOES happen as evidenced by the thousands of men who DO die every year from this disease.
So you can beat yourself up all you want for treatment choices (we all do sometimes) but as far as no treatment goes? I wouldn’t even consider it no matter how many studies they throw in my face…

Thanks for this post. I am at the very beginning. No surgery decision yet. 75 years old. Considering what to do. Surgery? No treatment? How many years without treatment?

Ever since I read this today I have felt angry and sad that I didn’t get several opinions on this subject. My Gleason was also 7 and at 78 I’m having buyers remorse since my surgery at Mass General in Boston did not get all the cancer with a PSA of .36 after surgery. Now with Hormone therapy and 6.5 weeks of radiation, no sex life and if I’m lucky I will lose 1-2 yrs of a life before I gave a chance of feeling normal and happy again. No Dr. has a crystal ball but if he said maybe 10 years without treatment, I would never have gone through this nightmare and there are many that cancer can return a third time .

Phil,
I completely agree . I do suspect at least in one case , my brother- in- law , failed the basic test of getting a 2nd opinion and more importantly staying with his " Favourite Doctor of many years " who in my humble opinion was a dinosaur" , unaware of the recent treatments and practicing decades old procedures . He stayed locally and never consulted with a "Center of Excellence ". And he could WELL AFFORD IT .
Who knows - approaching 90 he may have thought I had a great life , and this is thhe way I'm going out -- FATE ?
I also would not eliminate ADT if absolutely required .

@clandeboye1, Well, both in-laws were at an advanced age; and many much younger, active people die from heart attacks and strokes as well.
On autopsy, their arteries are completely clogged but because they were young and healthy no one suspected a thing, including their doctors. Perhaps your in laws were never even given physicals to address their cardiovascular condition before hormonal therapy, right? Who knows?
But metastatic cancer to the bone does a LOT to the body even when hormones are not involved. The high AlkPhos is a pretty good indication that your one in-law had a very advanced case.
Personally, I believe hormones have a very valuable place in the treatment of PCa; that said, I do not think they should be used in all cases. In fact, recent retrospective studies show lack of efficacy and even harm in some men whose recurrent PSA (post primary treatment) is less than 0.7
I am one of those men (PSA 0.18) yet I chose salvage radiation WITH ADT because I did have a full medical screening beforehand and I did want to give my RO every tool in the toolbox to beat this thing. How foolish would I have been to go thru 25 sessions of IGRT, have the cancer come back yet again, and hear the RO say, “Gee, maybe we should have used ADT as well…”. TOO LATE!!
Now I’d have to be on even more powerful drugs - some really full of side effects - or possibly ADT for life.
So that’s why I caution against saying “stay away from hormones” because they really CAN make a difference and change outcomes in many cases. I’ve got my fingers crossed, but come what may I have no regrets with my decision.
Phil

I think it is better to follow guidelines healthcare provider is recommending. Note that this Gleason score is a result of sampling of the biopsy conducted. This is only a limited samples that are indicative of this Gleason group. Nccn guideline is to have treatment for this Gleason score

Wish I considered that being. 78 yrs young

Thanks Phil, I hope so. I already run 30 or so miles per week and lift 2-3 times so will continue and maybe even increase the lifting a bit. And it's only 6 months.

My Urologist' s , plural ,did not cover this risk . Both my brother-in-laws passed as a result of these side effects . Plus a current associate is having cardiac related issues . I am aware that the ADT medications have advanced in recent years which mitigates these side effects -- but NOT TOTALLY . It is a much higher risk if you have a pre existing condition .

@heavyphil. Sorry I am not aware of which ADT they were on . Both passed 4 plus years ago .
One was two months shoort of his 90th birthday , Google : Dr. Hamish Small , a distinguished world renouned research scientist . His brothher passed at age 86 . Both were in excellent physical and mental health -- No pre existing issues , And both very active in : walking , golf , cross country sking , kayaking etc . Both surprisingly discontinued having a PSA . Hamish's cancer was diagnosed following a concerning " Alkaline Phosphatase number . Ian , from other indicators and finally a Biopsy . Both were Stage 4 when diagnosed . Both lived less than 2 years after diagnosis .