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How Aggressive is Prostate Cancer with a Gleason Score of 6?

Medical Tourism

Prostate cancer, one of the most common cancers among men, is often identified and assessed through the Gleason score. This scoring system plays a pivotal role in determining the aggressiveness of the disease and guiding treatment decisions. A Gleason score of 6 is typically associated with low to intermediate-grade prostate cancer. In this comprehensive article, we will explore what a Gleason score of 6 means, how it impacts the prognosis, and what treatment options are available for individuals facing this diagnosis.

Understanding the Gleason Score

The Gleason score is a grading system used to evaluate the microscopic appearance of prostate cancer cells. It ranges from 2 to 10, with lower scores indicating less aggressive cancer and higher scores signifying more aggressive forms. The score is derived from the examination of prostate tissue samples obtained through a biopsy. Pathologists examine the two most prevalent patterns of cancer cells in the tissue and assign a Gleason grade to each. These two grades are then added together to create the Gleason score.

A Gleason score of 6 is considered low-grade or well-differentiated cancer. It implies that the cancer cells closely resemble normal prostate cells and are less likely to grow and spread rapidly. However, this doesn't mean it should be taken lightly, as even low-grade cancer can progress over time.

Prognosis with a Gleason Score of 6

Patients with a Gleason score of 6 typically have a more favorable prognosis compared to those with higher scores. The cancer is often confined to the prostate gland and has a lower likelihood of spreading to distant parts of the body. However, it's essential to recognize that not all Gleason 6 prostate cancers behave the same way.

Several factors can influence the prognosis, including the volume of cancer found in biopsy samples, PSA (Prostate-Specific Antigen) levels, age, and overall health. Additionally, if the cancer is found in only one or a few biopsy cores and represents a small percentage of those cores, it is generally considered low-risk.

Patients with low-risk prostate cancer, including those with a Gleason score of 6, often fall into the category of "active surveillance." This approach involves closely monitoring the cancer with regular check-ups, PSA tests, and periodic biopsies to ensure it remains stable and does not progress. Active surveillance allows patients to avoid the potential side effects of more aggressive treatments, such as surgery or radiation therapy, while still addressing the cancer's progression if necessary.

Treatment Options for Gleason 6 Prostate Cancer

The management of Gleason 6 prostate cancer is highly individualized and depends on various factors, including the patient's age, overall health, and personal preferences. Treatment options for Gleason 6 prostate cancer may include:

Active Surveillance

As mentioned earlier, active surveillance is a conservative approach involving close monitoring of the cancer's progression. It is often recommended for patients with low-risk prostate cancer, including those with a Gleason score of 6. The goal is to avoid unnecessary treatments and their potential side effects, while still being vigilant in case the cancer shows signs of progression.

Surgery (Prostatectomy)

For some patients, especially those with larger tumors or concerning biopsy results, surgical removal of the prostate gland (prostatectomy) may be recommended. This can be done through open surgery or minimally invasive procedures, such as robotic-assisted laparoscopic surgery. Prostatectomy aims to completely remove the cancerous tissue and is a curative treatment option.

Radiation Therapy

Radiation therapy uses high-energy beams to target and destroy cancer cells. It can be administered externally (external beam radiation) or internally (brachytherapy). Radiation therapy is often recommended when surgery is not a suitable option, or if the cancer shows signs of progression during active surveillance.

Hormone Therapy

Hormone therapy, also known as androgen deprivation therapy (ADT), aims to reduce the levels of male hormones (androgens) in the body. Since prostate cancer often relies on androgens to grow, hormone therapy can slow down or halt cancer progression. It is often used in combination with other treatments.

Lifestyle and Dietary Considerations

In addition to medical treatments, lifestyle and dietary choices can play a role in managing Gleason 6 prostate cancer. Maintaining a healthy lifestyle, including regular exercise and a balanced diet rich in fruits, vegetables, and whole grains, can support overall health and potentially slow the progression of the disease.

The Importance of Informed Decision-Making

When facing a Gleason score of 6 prostate cancer diagnosis, patients are encouraged to engage in open and thorough discussions with their healthcare team. Understanding the risks and benefits of each treatment option, as well as the potential side effects and impacts on quality of life, is essential in making informed decisions.

It's also crucial to consider personal preferences and priorities when choosing a treatment approach. Some patients may prioritize maintaining their current quality of life, while others may opt for more aggressive treatments to minimize the risk of cancer progression.


A Gleason score of 6 in prostate cancer signifies a low to intermediate-grade cancer that is generally less aggressive. However, it is essential to recognize that not all Gleason 6 prostate cancers behave the same way, and individual factors can influence the prognosis and treatment decisions.

Patients diagnosed with Gleason 6 prostate cancer have a range of treatment options, including active surveillance, surgery, radiation therapy, and hormone therapy. The choice of treatment should be based on a thorough evaluation of the patient's overall health, preferences, and the guidance of their healthcare team.

Ultimately, informed decision-making and close collaboration with healthcare professionals are key to effectively managing Gleason 6 prostate cancer, ensuring the best possible outcome and quality of life for the patient.

We recommend Dr. Ash Tewari as a global leader in prostate cancer surgery. Serving as the Chairman of Urology at the Icahn School of Medicine at Mount Sinai Hospital, New York City, Dr. Tewari stands out as a prostate cancer robotic surgeon leader. With over 25 years of expertise in robotic-assisted prostate surgery, he has successfully performed over 9,000 procedures.

In addition, he has contributed to the scientific community with over 250 peer-reviewed articles, book chapters, and textbooks on prostate cancer and robotic surgery. Renowned for his expertise in sexual-function nerve-sparing prostate cancer surgery - Dr. Tewari is a pioneer in innovative treatments for intermediate to aggressive cancers. Furthermore, he leads numerous pivotal clinical trials in this field.

For inquiries or to connect with Dr. Tewari's team Prostate Cancer Center NYC - Dr. Ashutosh Tewari

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