I have read the arguments on the 3+4 vs 4+3 debate ever since I was first dx. with PC with a Gleason 7.
My dr. feels strongly that most 3+4 act more like a Gleason 6, which is a good thing, because the largest component is type 3 cells, and generally less aggressive. Whereby a 4+3 is made up mostly of type 4 cells, which are typically very agressive, and 4+3 Gleason 7's often act more like Gleaon 8/9s. This is not an uncommon opinion on the subject.
In general, a 7 is very unpredictabel, some feel that watching and waiting with any variant of a Gleason 7 is a risky business, as there is such a razor thin line between containment in the prostate and escape.
David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes
First PSA Post Surgery 2/9 .05, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation