That seems to be the case with most PC issues. The next generation of PC
victims can thank Bob Dole, et.al., for the much greater body of knowledge
than we had.

I.P.

Dave...This is an oft discussed subject.  Attached below is a study on
Gleason progression, although I'm not sure how convincing it is.  More
to the point, it has been shown that tumor DNA does change
significantly over time, both in terms of aneuploid content (Normal
cells contain two sets, or a pair [diploid], of chromosones.  Right
before the cell divides it will have 4 sets, or 2 pairs [tetraploid],
of chromosones.  Using flow cytometry, labs can measure the average
content of these two fractions in a batch of cells.  Of course the
diploid content is in great excess compared to the tetraploid content
in normal cells.  However in unstable [tumor] genetic material, a cell
fraction that is neither diploid nor tetraploid can be seen.  These
cells are said to be "aneuploid" and have an odd number of
chromosones.) and cytologogical differentiation.  Since most in the
medical community expect DNA changes to correlate with Gleason changes,
the working assumption has become that we are not born with Gleason 5,
but rather migrate to it over time, as our DNA becomes increasingly
corrupted with unstable aneuploid material...Best wishes and good
health, Ron

Br J Urol. 1990 Mar;65(3):271-4.

De-differentiation with time in prostate cancer and the influence of
treatment on the course of the disease.

Cumming JA, Ritchie AW, Goodman CM, McIntyre MA, Chisholm GD.

University Department of Surgery/Urology, Western General Hospital,
Edinburgh.

There is little information on histological changes in prostate cancer
during the course of the disease. We have studied 74 patients with
carcinoma of the prostate who required 2 transurethral resections of
the prostate (mean interval between resections 2.4 years). They
constituted 18.4% of all patients with carcinoma of the prostate
presenting to our clinic between January 1978 and April 1988. All
tumours were staged by conventional methods and graded using the
Gleason system. The Gleason sum score in those patients with tumour in
both specimens increased in 49, remained constant in 12 and decreased
in 7. Within this group were 34 patients who were treated expectantly.
The mean Gleason sum scores in this group increased, with a concomitant
increase in local tumour stage and development of metastases. Although
this was not a randomised trial, there was no significant difference in
survival between patients having "deferred" management and those
treated immediately, either from time of diagnosis or from time of
second resection. There was, however, a significant difference in the
time to second resection, with the "deferred" group requiring repeat
resection on average 1 year earlier. This study confirmed the concept
of tumour de-differentiation with time and showed that this phenomenon
occurs in both treated and untreated tumours. Although overall survival
was not influenced by the type of initial therapy or its timing, local
progression, as assessed by the need for further TURP, occurred earlier
in those not receiving immediate therapy.

If every cancer starts with the creation of one flawed cell and it can be
assumed that cell is a Grade 1, then time has to be a factor at least
initially.  I wonder if that is a matter of years or seconds.

Understandable.  There was a thread elsewhere in the ng dealing with
low PSAs and high Gleason scores.  

Thankfully, the "pimple" that my family doc found had not made its way
to the outside of the prostate.  I was one of the earliest men to have
the nerve saving technique in my area, and all has gone well since.

As long as I die with a fly rod in my hand, I could shive a git.  d;o)

Dave