To add my misunderstanding to what the Tall one is saying, Gleason 6 disease can turn into* a more-aggressive type with a higher Gleason score and that more-aggressive disease can metastasize. But it won't ever metastasize before
it changes to Gleason 7 or higher. That means that if there are metastases present then there will be Gleason 7+ cancer present (even if it used to be Gleason 6).
His statement one -- that "Metastases are never associated with a GS 6 found at pathology" -- looks backward in time and is true. Before
metastases can form there must be GS 7 or higher that can be found by a pathology. But his statement two -- that "GS 6 can never lead to metastases" -- looks forward
in time to falsely deny the possibility that GS 6 will lead to metastasis by the intermediate step of changing to a higher Gleason disease.
We frequently hear the statement "Gleason 6 never metastasizes" which, in a very narrow sense is true for the same reason that "A virgin will never give birth" is true, but it is prudent to remember that a man with Gleason 6 disease can still occasionally get screwed if he doesn't take care.
*One of the more technically dense and indecipherable threads we have had on this forum dealt with whether Gleason 6 disease turns into higher Gleason disease or whether the man simply develops Gleason 7 disease at more or less the same locations. From a patient's point of view it doesn't seem to make much difference but, thankfully, however it happens it doesn't happen that often.
63 Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012: 1&2 neg, 3 pos 1/14 6(3+3) 3-4% (2nd
opn. 7(3+4)), 4 neg
DaVinci 6/14/12. "some" nerve sparing on left
Path: pT3a pN0 R1 GS9(4+5)
Pos margins on rt
24 mo ADT3 7/12 - 7/14
Adj IMRT 66.6 Gy 10/17/12-12/13/12
8/2012-3/2015: Incont., Trimix, VED, PSA<0.015.
AUS & IPP installed 3/5/2015Forum Moderator - Not a medical professional
Post Edited (PeterDisAbelard.) : 10/7/2016 1:05:04 PM (GMT-6)