A question about differences between Gleason scores and cell mutations

Yes, I believe we are on the same page. And unless we are doing clinical cellular research it is pretty much a moot issue. But for us who frequent this forum, the bottom line is that Gleason 6 seldom metastasize while Gleason scores greater than 6 are more aggressive and even within each category there are variability.

The hard part is, how does one know that what is present is a true G6? The standard 12-20 core TRUS biopsy is random and can (and often does) miss significant tumors. The newer "mapped" biopsies are better, and the addition of the newer MRI techniques help as well.

Like it or not, the current state of affairs is that there really isn't a good way to know for sure that a diagnosed G6 is really G6 without surgery and a post surgery pathology study.