Treatment Strategies for Gleason 3+4=7 vs. 4+3=7 | Ask a Prostate Cancer Expert, Mark Scholz, MD

PCRI's CEO, Alex Scholz, asks medical oncologist, Mark Scholz, MD, about the distinctions between Gleason 4+3=7 and 3+4=7, temporary versus permanent seed implants, and the significance of seminal vesicle invasion.

0:05 What treatment options are available for men with Gleason 7 (3+4, not 4+3) prostate cancer?

1:23 How should Gleason 7 (4+3) be treated?

3:22 What seed implant therapies do you suggest, temporary (HDR) or permanent?

4:07 How should cancer in the seminal vesicles be treated and what are the risks?

5:23 What are the next steps after discovering spread to the seminal vesicles?

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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website or call our free helpline at 1 [phone] with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.

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[glenrose]

This 3+4 talk is spot on to my situation. Thank you so much!

[markbrown]

I REALLY BENEFIT FROM DR. SCHOLZ KNOWLEDGE. HE ROCKS.

[Jc-lkwn]

U are doing a wonderful job with these pod casts… thank you SO much 🙏🙏🙏

[kerstinandersson]

Sa glad I found this site! My husband just having high radiation for prostatacancer gleason 3 +4 and I learnt a lot Thank you!
Kerstin Andersson Sweden

[tomas]

I have one sample out of 18 3+4 very small. Getting hdr brachytherapy at Stanford with 5 treatments of sbrt radiation. Going aggressive. Want to retire in Alaska, so need to battle this now 😊

[steinshaw]

Thanks again. Seed implant was not an option for me as my cancer had escaped the prostate. I was a bit disappointed.

[hafben]

Very informative, thank you. Could you please address the relevance of family history. Thank you

[bhagmeister]

What a difference 10 years or so make in Dx and treatment options.

[sandraredmond]

Your advice is very informative and helpful. I would like to know if you are sponsored by any particular group or have any bias towards one type of treatment or another. It is so hard to know what to do when the dr tells you to do radical prostrate removal but you don’t want to live with the consequences. Is it foolish to not just have it removed or are these other treatments really safe and effective ?

[rubencostanza]

Good afternoon Dr, I am 61 years old and in a biopsy I have sample points 9, 10 and 11 with a Gleison 3+4 = 7, with 20%, 50% and 20% incidence... What do you recommend as a treatment? Thank you

[sandraredmond]

Could you discuss nutrition in light of prostate cancer please. Does a change of diet to illuminate sugar and animal proteins help?

[joegallo]

Did you know that some Gleason 6 and 7 are eligible for Active Surveillance? Dr. Peter Carroll, of UCSF, one of the pioneers in active
surveillance is kicking off the FREE "Active Surveillance & Beyond"
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Register for the July 30 webinar

[tomkuneman]

How does the PSA number relate to the duration of ADT for Gleason 7 (4+3). My PSA was 29, biopsy report was from John Hopkins.

[stevesohinki]

How does the fact that a patient has had a prior BPH procedure affect whether they are candidates for radiation treatment?

[Monk-Amani.]

Possible death is an issue, but I'm more concerned about discomfort and side affects after surgery.

[sureshtambe]

My psa is 12.3, my. Gleeson score is 3+3 in 11 out of 14, what will be treatment strategy

[normawong]

Why is it very difficult to find doctors that will do seed implantation?. We live in Florida. Even the VA does not offer brachytherapy. Thank you

[SadoRabaudi]

I was diagnosed with a 3+4, with 5 cores 3+3 and 3 cores 3+4 (so a high volume, but mostly 3+3), but one core had a very minor component of cribriform on one of the cores (this was one that was only 25% of the total core showing carcinoma with 10% grade group 4). How would this affect the treatment plan? The MRI showed no signs of metastasis, but am also having more imaging tests. My urologist has me scheduled for surgery, but I'm now leaning more towards wanting radiation.

[normawong]

Is the PSMA pet scan available for all patients? Thank you

[HFH-Official]

Well.... This sounds reassuring. I am a 47 year old PCA 4.8 and 3+4 and my doctor mentioned removing the prostate completely as one of the options.