Treatment for prostate Gleason 3+4=7 PSA 10 75 years old. treqemr?

My brother had 5 sessions of SBRT radiation at 77. They did give him a six month Lupron shot. Took him almost a year for the side effects to go away. He’s now 80 and his PSA is just fine.

He was a Geason 4+3. A 3+4 probably doesn’t need Lupron.

You might be able to get cryotherapy, TULSA Pro or some other form of focal therapy.

Were any of these things found in the biopsy intraductal, cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive.

Look into Tulsa Pro if they already recommend cryo. Cryo was the back up procedure if they found any calcifications while doing Tulsa for my 4+3. Click on my profile to see my Tulsa experience.

For favorable intermediate (w/no other risk factors), NCCN guidelines recommend RT w/o ADT. (See attached chart.)

At 65y, with a PSA of 7.976 and Gleason 3+4=7, I chose 28 sessions of proton radiation + SpaceOAR Vue. When a 2nd opinion upgraded the 3+4 to a 4+3, we simply added 6 months of ADT to the treatments.

My oldest brother (79y) was recently treated for a PSA 5.7 with Gleason 4+3=7. (There was some suspicion of lymph node involvement.). He had 28 sessions of IMRT + 2 years of ADT.

In making your decision, also consider your other numbers and test results:
> % Free PSA
> PSA Doubling Time
> PSA Density

> with your 3+4, what is the % of “3” and what is the % of “4”

> Some of these terms (from MRIs and biopsies) if mentioned are helpful indicators: cribriform pattern, extracapsular extension, seminal vesicle invasion, perineural invasion and intraductal carcinoma.
> Biomarker (genomic) test
> Genetic (germline) test
> Results from PSMA PET scan.

With that information, you’ll have much more insight into what treatment to have.

Wishing you the best.

I had 10.2 PSA and 3+4. I was contained to the prostate and no ADT used. I had 5 treatments in 2023 on the Mridian radiation machine that has a built in MRI. I chose the machine as it exposed less healthy tissue and minimized side effects vs other radiation machines. What the doctors could see because of the MRI, they could treat. I was 69 at the time.