The prostate cancer of low grade is technically a tumor, but over the years it has been realized that this definition could be a bit misleading.

Prostate cancer is diagnosed through a biopsy, during which the pathologist can also evaluate the degree of progression of the disease using the Gleason scale which defines prostate cancer as a score ranging from 6 (initial transformation) to 10 (advanced).

Tumors that have a Gleason Score of 6 are the least aggressive forms, with an often very slow progression, which are generally defined as low-grade or low-risk tumors.

Should we stop calling it “tumor”?

Given that these forms of prostate cancer can remain completely indolent for many years if not for the patient's entire life, urologists and oncologists are wondering whether it is not appropriate to begin to clearly distinguish them from prostate tumors which instead require therapies and treatments, starting with the name.

A recent article published in the Journal of Clinical Oncology brought this issue back to the fore. In this article, Professor Scott Eggener of the University of Chicago pointed out that Gleason 6 tumors are the weakest form of prostate cancer, adding that most are literally incapable of causing symptoms or spreading to other parts of the body. body.

The biggest problem with the definition of low-grade tumor lies precisely in the fact that the words "tumor" and "cancer" necessarily cause a great state of anxiety and stress, both in the patient and in his family. The risk involved in these cases is that the patient himself insistently requests radical treatment, even when there are the conditions to avoid it.

The patient subsequently feels safer for having freed himself from the disease forever, but enters a state of further anxiety and stress due to the side effects of the treatments.

In fact, from the available data it would appear that very few of those patients diagnosed with prostate cancer with Gleason 6 progress towards a more aggressive form of the disease in the following 5-10 years.

The general recommendation would be to try to correctly identify these patients in order to propose a protocol to them active surveillance, che include generalmente una serie di test del PSA regolarmente programmati, una risonanza magnetica ogni anno ed eventualmente una biopsia ogni due o tre anni.

The situation would be re-discussed from time to time based on new results, but as long as the disease remains stable it is possible to continue monitoring it.

There are obviously those who are against this idea of changing the name of this disease. No longer calling it a "tumor" could give a false sense of security to the patient, making him underestimate the situation, to the point of skipping check-ups.

The debate is therefore open and is a topic of discussion for several publications and presentations at major urology conferences worldwide.