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make a sound and rational argument for Gleason pattern 6 cancer being reclassified as something other than cancer. Their argument is largely based on the concept that Gleason 6 is not going to cause harm and therefore can be safely observed. The problem with this approach is related to the definition of cancer, flaws with drawing analogies to other examples of nomenclature reclassification, pathologic and molecular issues, and perhaps most importantly, practical issues surrounding optimal patient care.

There is strong support for retaining the carcinoma designation for GG [Grade Group]1 prostate cancer morphologically and molecularly and for clarity of reports and follow-up for patients. At the same time, many of the arguments for renaming GG1 prostate cancer with a noncancerous diagnosis have weakened over time with changes in grading terminology and greater acceptance of AS [active surveillance].

There is widespread agreement that some prostate cancer exists that is of no threat to the patient. The underlying clinical conundrum is how to identify those patients and how that would alter management. Simply, relabeling GG1 as a benign condition fails to address both these issues.

Read an interview about the commentary here.