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

cianci, I'm 78 too! Chose surgery, completed in May 2024. Subsequent PSA at 3 months= 0.009, and six months= 0.006. Not saying surgery is best for everyone but no regrets here. My detailed story in link below in reply to another post. It is a challenging journey! Mayoforums has helped me greatly.
Best
https://connect.mayoclinic.org/discussion/76-too-old-for-surgery/?pg=2#comment-1075893

What about Orgovyx? No shots, side effects minimal if you exercise and eat right. ADT (hormones) could be the game changer for you.

Well, I exercise and eat right, so I have those two things going for me.

There are lots of studies/trials out there that address this question. If you want a valid answer you should be looking there in large populations and scientific analysis rather than asking for one-off, anecdotal responses here. JMO.

Here is a link to one such study:
https://pubmed.ncbi.nlm.nih.gov/31909690/
and here is the abstract:

Abstract
Purpose: To study the risk of metastatic prostate cancer development in men with Grade Group 2
disease being managed with active surveillance (AS) at Memorial Sloan Kettering Cancer Center.
Materials and Methods: 219 men with Grade Group 2 prostate cancer were managed with AS
between 2000–2017. Biopsy was performed every 2–3 years or upon changes in magnetic
resonance imaging, prostate-specific antigen (PSA) level, or digital rectal examination. The
primary outcome was development of distant metastasis. The Kaplan-Meier method was used to
estimate treatment-free survival.
Results: The median age at diagnosis was 67 years (IQR 61, 72), the median PSA was 5 ng/mL
(IQR 4, 7), and most patients (69%) had non-palpable disease. During follow-up, 64 men received
treatment: 36/64 (56%) radical prostatectomy; 20/64 (31%) radiotherapy; 3/64 (5%) hormone
therapy; and 5/64 (8%) focal therapy. Of the 36 patients who underwent radical prostatectomy,
32/36 (89%) had Grade Group 2 disease on pathology and 4/36 (11%) had Grade Group 3.
Treatment-free survival was 61% (95% CI 52%–70%) at 5 years and 49% (95% CI 37%–60%) at
10 years. Three men experienced biochemical recurrence, no men developed distant metastasis,
and no men died of prostate cancer during the follow-up. The median follow-up was 3.1 years
(IQR 1.9, 4.9).

The key takeaway is: "Treatment-free survival was 61% (95% CI 52%–70%) at 5 years and 49% (95% CI 37%–60%) at 10 years."

Caution: This overall result is with all types of Grade Group 2 subgroups rolled up into one. The details of your pathology and imaging might mean you could expect shorter or longer times until you haveto seek treatment.

Life expectancy with a Gleason score of 7 (3+4) can vary, but many men live 10-15 years or longer without treatment, especially if the cancer remains localized and progresses slowly. In fact, some men with intermediate-risk prostate cancer live out their natural lifespan without symptoms or complications, particularly when closely monitored with active surveillance.

It’s worth noting that prostate cancer often grows very slowly, and many men with this condition die of other causes rather than the cancer itself. Regular checkups and PSA tests can help monitor the disease and catch any changes early.

While treatment can have side effects, there are also supportive therapies and lifestyle changes, like diet and exercise, that might help maintain quality of life and slow progression. Don’t lose hope—there’s a good chance of living many fulfilling years, even without aggressive treatment.

Excellent post! This is why Decipher and other tests are so important - not every Gleason 3+4 or 4+3 is the same…good find.

I too have PC, first suspected last March, PSA 5.2, then MRI showed something, subsequently confirmed by biopsy as Gleason 3+4, PSMA showed contained within gland and no spread. After a bunch of reading I couldn't decide on a treatment, but I swore I would not do ADT. I told myself I would have surgery before that. However, after having the Artera test (showed I have a biomarker that indicates a significant risk reduction with short term ADT) and speaking with a couple radiation oncologists and medical oncologists at different highly regarded cancer centers, well - I start Orgovyx tomorrow, with RT starting in 2 months. I exercise and eat well already, so hopefully it won't be that bad.

I assume your Gleason Score 15 is a typo . No matter , have a 2nd or 3rd opinion of your biopsy results before making any knee jerk decisions you may regret . Read Dr. Patrick Walsh's Book "
Guide to Surviving Prostate Cancer . YOU ARE NOT GOING TO DIE TOMORROW , YOU MAY HAVE HAD THE CANCER 10 OR 12 YEARS . Do you feel any different today than you did before your diagnosis . I agree , stay away from hormone treatment if at all possible . If you must go forward with treatment investigate , what is becoming the go - to treatment for low risk and favourable intermediate risk prostate cancer . SBRT 5 Treatments . Typically Mon-Wed-Fri AND Mon Wed the following week . I am on AS for over a year . I " MAY " consider MONOTHERAPY SBRT . Yes MONO -- no ADT etc .

Have you purchased Dr. Patrick Walsh's book : Guide to Surviving Prostate Cancer ?

Did your Urologist or others appraise you of the Stroke or Heart Atttack Risks of Hormone Therapy . Both my Brother-in-Laws died from the side effects of ADT . Stastically they did not die from cancer . BUT YES - THEY DIED AS A RESULT OF THEIR ADT SIDE EFFECTS . Some may say " Died from cancer related complications ."