Anyone is free to answer this for me, because I feel a little confused. On the subject of re-naming certain cancer cells to a non-cancer term, are we talking about type 3 cells, as in typical Gleason 6 (3+3)?
I think your confusion stems from what Gleason grade actually measures. It measures the degree of cellular dysplasia
. Dysplasia is an impairment of the normal cellular architecture and may include cells of unequal size, abnormally shaped cells, abnormal pigmentation and increased mitosis. Gleason grades 1-5 identify increasing dysplasia.
The reason that dysplasia is identified is because there is a strong association
between the degree of dysplasia and the virulence of its associated cancer. For example, cells with Gleason Grade 5 are also known to lack differentiation and multiply rapidly, and can easily live and grow outside the prostate (metastasize), while cells of Gleason Grade 3 or less have not been known to metastasize. Since 2005, Gleason grades of 1 and 2 are no longer reported because there was so little association found. Now, Gleason grade 3 is the lowest reported degree of dysplasia, and the score of 6=3+3 is the lowest reported score.
It was found that Gleason scores are strongly correlated with risk of not curing the associated cancer. So under the commonly used D'Amico risk categories, as adapted by NCCN, a man with a Gleason score of 6 and PSA<10 and stage<2b has been found to have low risk of recurrence if treated and NCCN endorses Active Surveillance for men who fall into that category. Their endorsement of AS for such men was based on the fact that their "cancer" seldom if ever progressed and could be adequately monitored. So Gleason score, PSA and stage (and sometimes # of positive cores & percent involvement) are the measures used to tell us how risky the associated cancer is -- they are properties associated with the cancer, not the cancer itself.