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@ozelli

You write that “ If I had found my PC at Gleason Score 6, I would have definitely had a radical prostatectomy” but the research clearly says that this would be a mistake. True Gleason 6 never metastasizes or at least close to never….99%.

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Replies to "You write that “ If I had found my PC at Gleason Score 6, I would..."

I am always skeptical of broad statements around medical procedures/advice. Each person is an individual, with the freedom to make the decision that meets his goals and life expectations.
As I always state, I believe the medical tools available today are fantastic and provide doctors with a lot of data to make their recommendations. However, they are not perfect and limited in their efficacy. For example - A quick search will show several studies around Gleason Score accuracy when compared to final radical prostatectomy pathology outcomes. Overall, correlation studies look to show that Gleason Score is approximately 55% - 60%, depending on Gleason Score. Same thing with biopsies, excellent tool/process, but not perfect. The biopsy does a great job confirming if there is cancer, but many studies show that biopsy-based Gleason Score rankings are not that accurate. Below are a few statements from the US NIH:
The most common Gleason score by needle biopsy and prostatectomy was five. 37.2% of all patients had no change in score assignment, while 12.7% were 'over-graded' and 50.1% 'under-graded' by needle biopsy.

Of 241 cases 45 (18.7%) showed a significant change in grade from Gleason score 6 or less to Gleason score 7 or greater (Gleason score 7 in 41 cases, Gleason score 8 in 4 cases). Of 45 (53.5%) cases 24 that showed progression did so within 24 months of diagnosis.
Within the first 3 years, our data suggest that in most cases tumor grade did not evolve but rather that the higher grade component was not initially sampled.

Overall lay-man's recommendation - Take all the available information into account and make the best decision that aligns with your life expectations. Try to ignore the "this is the best option" and "why would you ever do that procedure" comments.

Best of luck and have a great weekend,

Jim