Should I choose surgery or radiation for Gleason 7 prostate cancer?

My Gleason score is also 4+3=7. PSA is 6. I had an appointment with my surgeon Oncologist and after a 30 minute consultation I am opting for a radical prostatectomy. I am 70 yrs old and very healthy. I eat clean and work out 4 days per week. This is my choice at this time but I do have three appointments this week at Dana Farber in Boston. One is a prostate specific PET Scan, another with a radiation Oncologist and the other with a medical Oncologist. I can keep you updated with my progress. I have scheduled a date for surgery, Dec 12th. I can always cancel if I choose another option later this week.

I thank you and I appreciate it. I know that all cases are different and I think I'm leaning more toward the radiation treatment. Only because it'll probably be more difficult for me to not work for a month and looking at some of the side effects like ED and urinary problems . we have almost the same scenario and either way it goes surgery or radiation therapy they're both good options and have the same cure rate. Praying for us all 🙏🏿

My Gleeson score was also 7. I had surgery in 2016 and radiation in 2023. I also had a PET scan in 2023. My PSA is now zero. Happy to share my perspective, if helpful

This is such a challenging decision, and it sounds like you're being thoughtful about gathering information from different specialists. Having a radiation oncologist confirm that both options could work well for your specific situation is encouraging news. Many community members have faced this same choice between surgery and radiation, and hearing from others who've walked similar paths can provide valuable perspective alongside your medical team's guidance. Consider sharing more about what factors matter most to you in your treatment journey - others here may have insights about their decision-making process that could help inform your choice.

If you’re given the opportunity-DO RADIATION FIRST!! You can always have a prostate removed if something changes. Radiation-depending on the form-typically has much less side effects. I am 60 years old,PSA 5.7 Was on testosterone therapy for last 10 years, now titrating off it. I have 1 spot that is a 4+3 Gleason score, the rest were 3+3 and3+4. My regular urologist said it’s either total removal or 6 weeks of radiation-BS!! I called Sloan Kettering in NYC-they got me in in 3.5 weeks. I was able to see a Oncology Radiologist, as well as a Surgeon (hoping focal treatment was on option-which it is as a 3+4 but not 4+3-uggh) all at the same visit. Dr is not recommending hormonal suppression at this time. Were your cells benign or no?? Your options change if squamous cells. Mine fortunately, were not. From all the research, Low dose radiation has a lot more side effects. Anyway, I leave for NYC (a4.5 hr trip) and on Tuesday-they’ll put me under anesthesia-place gold markers so there’s precise location where they want to do radiation, a rectal spacer (a gel/chalk they inject between the rectum and prostate-which decreases any radiation side effects from 30% to less than 2% ) And then while I’m under anesthesia, do a 1 time super intensity radioactive seeding for 7-12 minutes only (a form of brachytherapy ) Then it’s back home. 2 weeks later a follow up CT Scab and MRI Then, 2 weeks later-5 days of high intensity radiation then all done, then one month, 3 month, 6 month, 9 month, 12 month follow ups for now. Don’t sell your self or your family short-go to the research hospital and get the best care vs the convenient care. Hope this helps give someone an awareness that there are so many more options.

Thanks for this I'm about to go down this same road like you. It kind of confirms all my research and looking into it. I have the spacer put in next week can you tell me a little bit about the procedure how long is it and any other thing is important I need to know.