Does prostate cancer start as low Gleason Score?

Diagnosed with Gleason score 9. Did the cancer start at a lower Gleason score and grow into the higher 9?

Post Edited (NewHere123) : 2/12/2019 4:45:15 AM (GMT-7)

No. G6 is known, but not proven, to stay G6. As a G9 you have some combinations of 4 and 5. You can also have Grade 3, but in small amounts that were not used to determine your G score. Remember it is the sum of the two most prevalent grades in each biopsy core.

G7 and above can and do mutate to higher G levels. Some will eventually mutate to cancer cells like small cell, which bear no resemblance to the prostate cells they came from. Since it starts with very few cells mutating and we can not be diagnosed until there are many millions of cells making a tumor or tumors large enough to express more PSA we can’t actually know the real starting point. Research is focused on the PCa stem cells as they are the starting point.

Some specialists label G6 as pseudo-cancer since it can not spread or love outside the prostate area. G7-10 can and will spread and cause damage.

No. But the first PC that most people grow is the very common 3+3.

It doesn’t “grow into” something else, but something else might also grow...

That’s a question I’ve always meant to ask the urologist. I am\was a G7.

I did ask my urologist how close I was to potentially cancer leaving my prostate. He said that in his opinion, 6 months it could have spread outside.

Thanks for the information!

You all take care!

Wilderness, I’ve never looked under a microscope at prostate biopsy slides*, but those who do for a living say GG4 and GG5 are challenging to tell apart, but both are much different than GG3.

*I’ve seen the photos of slides in books, etc, and I can’t tell any of them apart.

Wilderness, I generally agree with your comments...there is judgement.

I'm not sure what you even meant by "I don't think there can be a hard line," but I didn't mean to describe any "hard line" at all...so even though I don't know what you mean, I guess I agree! LOL

I'm in a bit of less agreement with your comment "Experts can look at the same slide and give different readings." Since it does involve judgement, even amongst a panel of experts, studies of clinical samples have shown some limited variation, but not as significant as the variation from what they call "community" pathologists and "experts." Moreover, the "expert" general consensus on clinical results has lined-up much more consistently with the histological pathology...which is absolutely why we encourage men to have their slides read by an "expert." Maybe what you meant to say was that "Two pathologists can look at the same slide and give different readings"...I would agree more wholeheartedly with that.

here's a pic of the Gleason scale:

https://www.prostateconditions.org/about-prostate-conditions/prostate-cancer/newly-diagnosed/gleason-score

A cancer cell is a normal cell that has mutated into a cancer cell due to damage to it's DNA. It can continue to mutate, as a G3 can turn into a G4 can turn into a G5

trailguy said...
here's a pic of the Gleason scale:

https://www.prostateconditions.org/about-prostate-conditions/prostate-cancer/newly-diagnosed/gleason-score

A cancer cell is a normal cell that has mutated into a cancer cell due to damage to it's DNA. It can continue to mutate, as a G3 can turn into a G4 can turn into a G5

trailguy, probably not intentionally, but your words (particularly those I put into bold, above) seem to be misleading (and wrong). May I offer this clarification.

First and foremost, don’t be confused by the visual “continuity” of the Gleason scale diagram you linked to…it is absolutely NOT the situation that prostate cancer cells actually change/evolve/migrate over time as your words seem to have implied. Rather, PC cells remain (as the saying goes) “as they were born.” The continuous scale diagram is merely created for visual comparison purposes…imagine the situation where you are a student pathologist looking thru a microscope you have a sample in front of you; use the diagram to determine which cells look most like the sample in front of you? (This seems to be an example of the "danger" of putting information--the diagram--intended for the professionals into the hands of lay persons...the danger is the misinterpretation of the information by people it was never intended for.)

The root of the issue with trailguy’s post is the misuse of the word “mutate.” I’ll explain…

Genes mutate. Cancer cells don’t mutate. Cancer is produced from mutated, malfunctioning genes, but prostate cancer cells themselves don’t change or “mutate.” They are, as I mentioned, as they were born: a Gleason pattern 3 cell when born, for example, remains pattern 3. Other cancer cells may develop on some other day and in some other location which may be different, but they too will remain as they were born.

Let’s understand gene mutation better. As mentioned, cancer is a direct result of mutated genes that can no longer participate in the healthy development and growth process. For every type of cancer, there is a specific set of genes thought to contribute to it. Having mutations or abnormal variants of these genes doesn’t necessarily mean that a person will develop an associated condition or type of cancer, but rather, means that their risk is increased. For this reason, possessing these mutations is considered a risk factor until the mutations start to cause a disruption in healthy gene function. When the function of a gene is altered and it begins to contribute to cancer growth, then it develops into a cause. A cancer "risk factor" and "cause" are different.

For prostate cancer, there are several genes that have been linked to the potential development of the condition. In 5-10% of prostate cancer cases, these mutated genes are inherited (from our parents), while other mutations can be individual-specific and acquired through exposure to environmental factors, such as cigarette smoke, Agent Orange, or radiation. Even though it is only a small percentage of PC cases, the inherited BRCA1 and BRCA2 genes have gotten a lot of press recently—probably everybody know that these gene mutations are associated with breast and ovarian cancer in women, and prostate cancer in men.

Besides (i) hereditary and (ii) environmentally caused PCs, the largest group (about 75% of all PC cases) is actually (iii) “sporadic” cancer. As an interesting side-bar fact, sporadic prostate cancer is so ubiquitous and common that even if there is more than one case in the family, there is typically no particular pattern of inheritance. On this point, Dr Patrick Walsh once said: "Prostate cancer is so common that even if there is a hereditary factor, there will be other members of the family who will get the disease sporadically."

It’s very likely that trailguy did not intend to mislead…please forgive me if it seems like I implied otherwise...but a little review of human biology seemed appropriate in this thread.

Post Edited (Blackjack) : 2/15/2019 12:16:39 PM (GMT-7)

Blackjack said...
Informative LINK

?

trailguy said...

I look forward to seeing your contribution to the science here, also reading your stats in your signature line.

I make a point to not post personal information/data on the internet. It’s a rule violation at sites like HW/PC to ask others for their info for good reason. When it is relevant to a particular thread, I do sometimes make selective exceptions and speak about my own case history—10 years of it. My case history is not, however, relevant to this thread. If you’d like, you can search thru my old posts and find all the details...many times over. While you are in search mode, check out any high school biology book to learn about cells, genes and heredity.

three 5's and a jack said...
True: one's personal info/data is not important as concerns a thread started by someone else unless you want/expect the OP and others to accept your statements as valid.

Roger

Let’s put that to the test. Let’s see...trailguy posts his personal data/info to everyone, yet he perpetuates BS myths. Your hypotheses is demonstrated invalid. But based on your signature, maybe we knew that.

Ignore my comments if you wish. It’s a good site feature. I have 2 people on ignore.

I am inspired to try the ignore function for the first time. I have resisted in the past because it rubs me the wrong way to think that someone could be that annoying.

I will try it out.

This issue of “can Gleason 6 grow into a higher grade?” Is one of the most debated topics on PCa forums. It is active on two other forums right now, for the umpteenth time.

And, it need not be. The answer is NO.

BlackJack and SrSailor provided the quotes and citations on February 14th.

That should have settled the matter, but, as elsewhere, folks like to needle each other.