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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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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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 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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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 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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@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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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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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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How long YOU can live with Gleason 7 (3 + 4) prostate cancer depends on so many variables -- your age, fitness, pre-existing conditions, PSA, prostate size, stage of your cancer, nodal involvement, etc etc etc.

Anyway, educate yourself on Active Surveillance:
https://www.youtube.com/watch?v=8Avzm3Y8J8U

And consider getting a PSMA PET Scan:
https://www.youtube.com/watch?v=eFCctzBiZM4

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@milburnd

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.

Jump to this post

Very interesting! This is the first I've heard of this approach. From what I just read online, it is an offlabel treatment for prostate cancer that has been approved for cancers in the liver and pancreas. It works by placing 3-5 needles around the tumor and generating a current between them during the interval when the heart is not beating (to avoid interfering with heart rhythms. As such, it works best when there is one or very few nodules of well-contained cancer cells, which could be a gleason 3+4.

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