Gleason 7 (3+4) options

Next step would be an MRI if you haven't had one yet. Also I would do a PSMA CT/Pet scan. If that was clear you would have many options. The last thing I would do with a Gleason score 3+4 is remove the prostate. You should be a candidate for AS (Active Surveillance) which is do nothing but test PSA & maybe scans periodically. You didn't mention what your PSA was? Here in the states the routine is high PSA or abnormal DRE, MRI, Biopsy if anything shows on MRI, then a PSMA CT/Pet scan. 

Many men are on active surveillance for many years. You may very well die with prostate cancer "NOT" from it. Prostate cancer is typically a slow moving cancer so no need to rush into anything. Don't be pushed into surgery!!!  

Good morning and welcome.

This is a good group to be in, although none of us really wanted to be here. You will get loads of help from lived, practical, experience rather than medical expertise.

There should be more options than surgery or active surveillance.

Your Gleason score is into the “not too bad” end of the spectrum so active surveillance might be good, however, some of us are more in the “see it, kill it” bracket.

You might also want to be referred to an oncologist to review other options, because they do exist. Given your age and the state of the cancer you have there are a lot of choices, unless they are ruled out by the diabetes.

You have the time to seek advice and make the right decisions.

I wish you very well in your journey. Keep us posted!

Hi Robinhood494 , sorry you have been diagnosed with PCa.  I was intrigued by your comment 

Robinhood494 said:

At 50 years old I feel I'm to young to loose my prostate

Personally, I am not a great advocate of having a prostatectomy but at 50, in my mind that would be the best age.

Do you have any idea of the tumour size and position?  I agree with Steve (mstev2 ) to get to see an oncologist and then review your options.

Hello Robinhood494 

Another warm welcome to the online Community from me too, although I am so sorry to find you joining us.

I am fully in agreement here with Steve (mstev2 ). You've seen the urologist, he's offered what he can do (surgery), however you need to speak to an oncologist too - this option should have been offered to you.

There are other treatments, Radiotherapy, Hormone Therapy and Brachytherapy as well as Active Surveillance.

As people who know me, I am not a fan of AS (it's cancer - it's not going away) however that's a personal thing. You need to explore all options open to you - you also need to look at the side / after effects of each treatment too as not only will the treatment affect you - it will affect any partner too.

There's lots to take in, but please do ask questions, you have time to make your choices as a Gleason 7 is a slow growing cancer. 

Best wishes - Brian.

Hello Robinhood494,

I'm very sorry to hear of your diagnosis, especially at age 50.

As others have said, I would most definitely insist on seeing an oncologist rather than just settling on surgery or active surveillance as your only options. You really need to be fully aware of all treatment options to make an informed decision that is best for you.

As far as your final question is concerned cancer is cancer, but with prostate cancer very long survival rates are common, all the more with a low gleason score and no spread like yours. I was diagnosed in 2016, had radiotherapy and 7 months HT then was OK until 2024 when my PSA crept up and tests showed local recurrence. I had more treatment and am still leading an active life, making several overseas trips a year and intending to celebrate my 70th birthday this year in my favourite city, Tucson Arizona.

I wish you all the best, do keep us informed and ask us anything else you want to,

Derek.