Gleason 6 (GG1) – Should It Be Called Prostate Cancer?

Jeremy Slawin, MD, MBA, presents arguments for and against the reclassification of Gleason 6 (GG1) as something other than prostate cancer. He begins with a brief overview of the definition and perception of prostate cancer, and the psychological burdens and implications which come with cancer diagnoses.

Dr. Slawin then addresses the growing momentum in favor of a change in nomenclature for Gleason 6 (GG1) that does not include the word “cancer,” as has been done for diseases like noninvasive follicular thyroid neoplasm with papillary-like features (NIFTP), formerly called papillary thyroid cancer. Dr. Slawin presents data supporting the idea that GG1 is closer to pre-cancer in clinical behavior, detection, and management, and that calling it a cancer may drive overtreatment of GG1.

Dr. Slawin then turns to arguments against the reclassification of GG1. He addresses the issue of undersampling in biopsies which lead to GG1 diagnoses, the risk of under-grading, and how failing to call GG1 “cancer” could give a false perception of risk and lower the already-low patient compliance rates in active surveillance treatment.

Dr. Slawin concludes by giving his perspective on the issue of changing the nomenclature for GG1. He, along with most pathologists, is not in favor of reclassifying GG1, and leads a Q&A with the audience to gather their perspectives.

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