From what I have read it is a mixed bag.
3% of gleason 6 tumors are very agressive. They will have already progressed at diagnosis or will progress rapidily within 6 months. about
70% will never progress or progress so slowly that they will never hurt you. The remaining 22% will progress to G7 in a few years, I assume that these will eventually turn into G8 many years later. This corresponds to the fact that those on AS who get treatments years later have the exact same cure rate as those G6's treated immediately.
There are some experts, mostly urologists, that say that all cancers will eventually turn agressive. Almost all oncologists believe there are agressive cancers and non agressive cancers and the only way you can tell is watching how it acts over a period of time. Many more doctors are now believing in the later as more information is getting out. Since PC kills about
10% of those diagnosed it's pretty obvious that the majority of PC is non agressive. There is a reason to believe that younger patients may have more agressive PC, G8 and above, but I have never seen any studies to back this up.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.