This report was fascinating to me:
Gleason Grade Progression Is Uncommon
US National Library of Medicine
National Institutes of Health
Cancer Res. 2013 Aug 15; 73(16): 5163–5168. doi: 10.1158/0008-5472.CAN-13-0427
Especially this abstract:
the knowledge that Gleason score largely does not progress may make the choice of active surveillance more appealing for patients with low grade disease.
If we suppose that a Gleason score 3+3 will remain 3+3 for the entire course of the disease, active surveillance could be considered a definitive treatment for selected patients with ≤10 years life expectancy and could significantly delay (potentially forever) the treatment of selected patients with >10 years life expectancy. This option would prevent side effects from radiation or surgery for patients who do not need these more aggressive treatments.
So does that mean my 3+3 in 2002 may still be the same in 2018? PSA in 2002 was 2.5. It went to 11.1 this spring and now is 10.0.
Yes, I'm wondering about another biopsy. Would it be wise or unwise at age 81?