How can Gleason score change from 6 to 7 with stable PSA levels?

Changes in Gleason scores between biopsies can happen even with stable PSA levels, and this situation raises important questions worth discussing with your medical team. Prostate biopsies sample only small portions of the prostate, so it's possible for areas with different grades to be missed in earlier biopsies, which could explain the grade progression you're experiencing despite consistent PSA readings. This kind of uncertainty during active surveillance can feel overwhelming, and many others in this community have navigated similar concerns about biopsy results and what they mean for their care plan.