Prostate cancer diagnosis can be a life-altering event for men, but the cancer isn’t always a cancer. This is the issue facing many men and their doctors when it comes to GG1 prostate cancer, also known as Gleason 6 prostate cancer.
GG1 prostate cancer is a precancerous condition that cannot spread, but may lead to cancer.
Current Guidelines and Recommendations
Guidelines recommend that men diagnosed with GG1 stick with active surveillance, which includes prostate-specific antigen (PSA) testing, magnetic resonance imaging (MRI) scans, and regular biopsies to make sure it has not progressed to become cancerous.
One exception might be young men with a strong family history of prostate cancer or a gene that puts them at increased risk for the condition.
Providers are legally obligated to tell their patients they have cancer, a diagnosis that has a very strong emotional effect.
The Impact of the “Cancer” Label
Using the word “cancer” to describe GG1 can lead men to seek prostate cancer treatments that do more harm than good.
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In the U.S., about 1,000 men a year are diagnosed with GG1 and up to 40 percent of them opt for treatment.
Removing the cancer label can significantly reduce overtreatment, a new study led by researchers at the University of California in Los Angeles has found.
It may also lower the number of prostate cancer deaths by encouraging more men to get screened and continue with screening.
Redefining Conditions and Terminology
“Medicine has a history of redefining conditions when the terminology no longer accurately reflects risk,” Scott Eggener, senior author on the study and chairman of the department of urology at the David Geffen School of Medicine at UCLA, said in a statement.
Eggener pointed out that similar changes have happened in other cancers, such as bladder, cervical, and thyroid cancers.
Men diagnosed with GG1 should think of it as a nasty skin mole, rather than a cancer.
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The researchers created a mathematical model to predict the risks and benefits of relabeling GG1 prostate cancer as GG1 prostate disease.
When they plugged U.S. population data and data from previous studies into the model, they found that relabeling GG1 could prevent about 2,835 prostate deaths a year if more men got screened, and it would cause 452 deaths if fewer men got screened.
These findings highlight the need to reconsider how providers discuss low‑risk prostate cancer with men.
“Even if it is not an aggressive form of cancer, it is still cancer and it frightens patients,” Andrew Vickers, first author on the study, told TheDoctor in an email.
Vickers, a researcher in the department of epidemiology and biostatistics at Memorial Sloan Kettering Cancer Center in New York City, said men diagnosed with GG1 should think of it as a nasty skin mole, rather than a cancer.
The study and a related editorial are published in JAMA Oncology.
