Question about Gleason 6

I am just curious to know if you can get terminal mestastic PC with Gleason 6, or does it need to first change to Gleason 7, then to 8, then 9, and finally 10 before you actually die?

I am by no means an expert or even close to one but I was daagnosed with Gleason 3+3 at biopsy and Stage T1c with a PSA of 3.2 at age 58. Biopsy showed 7 of 12 samples showed 5%-40%.

The pathology report came back with Gleason upgraded to 3+4 but with clear margins. They did note though that the surgeon had taken a little more out around the prostate and that the cancer was just on the verge of escaping the gland.

So can a 6 be of concern to bigger issues? Normally, from all of my reading, my answer would be not likely. But yet, I almost crossed that threashold. So my message would be not to worry about it too much until you get the pathology report (assuming you have surgery) and then take the next steps as necessary.

Gleason 6 seldom metastasizes..It's not impossible, but it's pretty rare, maybe a 10% chance? If it does metastasize, it's usually to a large bone and that cancer also grows slowly and it can be successfully treated with radiation or hormone therapy..

Very few men die from prostate cancer that began as Gleason 6 ...

Gleason grades seem to be pretty stable. What begins as a G-6 usually stays that way even if the disease progresses..But not always..There are cases where G-6 tumors seem to mutate into a more aggressive form..This makes "Active Surveillance" tricky business..

The progression of this cancer is almost impossible to predict on an individual basis..Every case is a little different.. Good Luck..

NY Sooner:
You are most certainly NOT asking about yourself. Your situation has been dealt with permanently.
G6 can become metastatic if untreated. This occurs in one of several ways. The tumor can grow, in place, until it spreads to surrounding tissue. It can also develop, over time, to a more aggressive type, a G 7 and above and thus infiltrate widely. This is a natural progression of the disease. For men who die of their cancer, the G score of the remaining disease is nearly always G 8-10 by the time of demise. This is called the de-differentiation of the diseased cells. They become less normal and more primitive, as the cells which remain alive after a series of treatments is made up more and more of the most damaged cells. A kind of reverse evolution.The good news is that even if initially untreated, the G6 will respond for long periods to hormone and radiation treatments and survival is usually greater than for those with higher G scores at diagnosis.

He had indolent cancer. His biopsy figures were well within the Active Surveillance guidelines. He chose surgery at a top rank institution with one of the very best surgeons available. His pathology was clear and clean. His more than two years of undetectible psa means his chance of recurrence is vanishingly small. I believe he is cured and his pathology and psa numbers support this view. I believe his doctor will say the same. I see him as among the 9,999 and not the 1 in 10,000.