Gleason 7 (3+4) localized prostate cancer

Hi PM and welcome 

Do u have any more stats available which will help give the best advice 

IE as many PSA s that u have , what does the MRI say especially in terms of tumour size in mm 

Best wishes 

Steve 

Hi Steve, thanks for your prompt reply. My cancer is 4mm long. My two PSA scores were  4.6 and 4.3. There were 17 samples taken in my biopsy - 95% were pattern 3, 5% pattern 4 (hence 3+4 Gleason 7). That's pretty much all the info I have at this point. Best regards, David

Hello Piano man and welcome. As Grundo has said, it is difficult to give you targeted information as you only have part of the picture. You need to find out how many of the 17 cores showed unusual cell morphology, where they are in the prostate and what type of prostate cancer you have. I have attached a link to a very helpful book which you can download for free which is a good starting point to understanding prostate cancer.

https://www.jyotishah.com/fighting-prostate-cancer-a-survival-guide/

To treat or not to treat is a difficult decision, as is the type of treatment you choose to have so I would make a list of what is important to you and then look at the possible side effects of each option. From the initial information you have given it looks as if a focal therapy might be suitable as you have a low PSA and a small tumour.

Please come back with any questions and we will try and help.

Really helpful. Thanks Alwayshope!

So that's all quite low really and similar to me when I started out in 2013.

I also had two tumours similar size , I went on AS for ,,4 years and in the time the largest tumour went to 13mm and that's when I started treatment.

Looking back I should have started treatment a bit earlier cos getting near capsule edge.

So AS looks ok for now but Def keep your eye on it, u need yearly MRI at least and 3 or 4 PSA tests.

All the best

Steve

Hi PM

Sorry to hear of your diagnosis and side effects of the biopsy. Hope you make a speedy recovery. It is fortunate that your pc has been caught very early and a complete cure almost a certainty.

I am not a medical professional but am a little surprised that they have suggested watchfully waiting at your young age. Did they say why? I am guessing that as PC can be very slow growing, they are waiting to see if the tumour gets any bigger before deciding on treatment. Older people are sometimes put on active surveillance as the tumour may not cause a problem within their life expectancy (I e. More likely to die of old age).

There are, however, people on here who have had bad results from waiting too long and may be able to comment.

My own view, for what it's worth, is the earlier you get treated the better. PSA results are notoriously unreliable. I had PSA scores of 3 and yet my biopsy showed significant tumors close to the edge of the prostate. Fortunately, I've made a full recovery after having surgery a year ago. If you do decide to wait, insist upon regular scans.

Please feel free to ask me anything.

Cliff

Hello Piano man 

A warm welcome to the Macmillan Online Prostate Community from me.

I am in agreement with LTC61 here -  but it's only my personal opinion too:

LTC61 said:

My own view, for what it's worth, is the earlier you get treated the better.

But:-

* A Gleason 7 (3+4) - Most cancer cell will grow slowly - but it's likely some will grow at a moderate rate.

* All 17 samples taken from your biopsy contained cancer.

* You are not getting any younger and the cancer isn't going away so get it sorted whilst you are still fit(ish!)

I agree too with the post from Alwayshope above - it's important to you to work out what treatment would be best as at this moment you would have the choice of Surgery, HT/RT or Brachytherapy.

I do hope the above helps - please feel free to ask any questions you may have.

Best wishes - Brian.

I suspect that some of your 17 biopsy cores did not contain cancer. It would appear that in the cores that were positive, 95% of the cancer was grade 3 and 5% was grade 4.

Active surveillance should not be considered with 17 of 17 cores positive regardless of gleason score. Please check your biopsy report to confirm how many of those seventeen cores contain cancer. This detail is important. 

• I had 18 cores taken, 12 from the right half of my prostate & 6 from the left, 12 from the 12 contained cancer and 3 from the 6 on the left contained cancer, my score was 3+4 with T3a and I had my prostate removed by robot on July 5th this year, I was declared free of cancer on September 23rd. 
  
  
• Far better off with an op in my opinion, I had suspected cancer in February 2024 confirmed as cancer in April 2024, removed in July 2024, confirmed cancer free within 7 months in September, I’m now getting on with my life and moving on

          Take care to all

          John

Thanks everyone who has shared advice and insights. Really helpful. Can't thank you enough. I had further details about my biopsy today - of the 17 cores taken, only one tested positive for PC. There was no evidence of cribiform cells.I'm scheduled to have non invasive and surgical appointments to discuss options within the next two months. I'm pretty certain I'm not going to stay on 'active surveillance' very long - it just feels too hard to passively sit back waiting for the situation to get worse before action is taken.

Best

PM