How does the Gleason scale work?

Gleason scores of 5 or lower are not used. The lowest Gleason score is 6, which is a low-grade cancer. A Gleason score of 7 is a medium-grade cancer, and a score of 8, 9, or 10 is a high-grade cancer. A lower-grade cancer grows more slowly and is less likely to spread than a high-grade cancer.

How is the Gleason scale calculated?

The Gleason score is determined by adding the two most common grades. For example, the most common grade of the cells in a tissue sample may be grade 3 cells, followed by grade 4 cells. The Gleason score for this sample would be 7.

What do the numbers in a Gleason score mean?

The highest a Gleason score can be is 10. The first number assigned is the grade that is most common in the tumor. For example, if the Gleason score is written as 3+4=7, it means most of the tumor is grade 3 and less is grade 4, and they are added for a Gleason score of 7.

What does a 7 on the Gleason score mean?

Intermediate Grade: Gleason Score = 7: A score of 7 means that the patient has a 50/50 chance of having aggressive prostate cancer. If the patient received a primary grade of 3 and a secondary grade of 4, more than likely the cancer will grow slowly.

What does a Gleason score of 4 mean?

This distinction indicates how aggressive the tumor is. Scores of 3 + 4 typically have a good outlook. A score of 4 + 3 is more likely to grow and spread than the 3 + 4 score, but less likely to grow and spread than a score of 8. Some people receive multiple Gleason scores.

Understanding The Gleason Score | Prostate Cancer Staging Guide

What is the difference between a 3/4 and 4/3 Gleason score?

A Gleason score of 4+3 versus 3+4 was predictive of metastatic disease (P = 0.002) but not local recurrence. Conclusions: Gleason score 7 tumors are heterogeneous in their biologic behavior. The differences in prognosis for patients with Gleason scores 3+4 and 4+3 tumors at radical prostatectomy are significant.

Can a Gleason score go down?

The decrease in proportion of high Gleason score cancers, however, was due to higher rates of low-grade disease diagnosis as a result of PSA screening. The researchers show that the shift in Gleason score proportions over time is not likely due to changes in the age at diagnosis.

What is the life expectancy of a Gleason score 7?

Maximum estimated lost life expectancy for men with Gleason score 5 to 7 tumors was 4 to 5 years and for men with Gleason score 8 to 10 tumors was 6 to 8 years.

Should a Gleason score of 7 be treated?

In contrast, patients with Gleason 7 to 10 cancer should consider treatment (i.e., radical prostatectomy or radiation). These patients have a high risk of dying from prostate cancer, and disease-free survival appears to be better after treatment.

Can a Gleason 7 metastasize?

According to Dr. Klotz, the likelihood of metastases was mainly dependent on the amounts of Gleason 7 cancer in the prostate, and whether a man's PSA levels doubled quickly. He expects that a few more men in the study will develop metastatic cancer with age and longer-term follow-up.

Is Gleason 9 a death sentence?

Not all men with Gleason 8-10 disease are going to do badly after treatment. There is a perception among a lot of patients — especially when they get diagnosed — that having a high Gleason score of 8, 9, or 10 is essentially a “death sentence”, regardless of how they get treated. This is not actually the case at all.

Can Gleason score 8 be cured?

Curability of Prostate Cancer

Walsh and associates recently reported on the long-term survival for men with Gleason 8–10 adenocarcinoma who underwent radical retropubic prostatectomy. In this series, the 5-, 10-, and 15-year biochemical disease-free survival was 47%, 29%, and 15% respectively.

Is Gleason score 10 curable?

“Overall, we found that survival outcomes following definitive treatment for Gleason score 10 prostate cancer are actually quite good, with 5-year overall survival rates approaching 80% regardless of treatment modality,” said study investigator Amar U.

What is Gleason score based on?

The Gleason score is determined by adding the two most common grades. For example, the most common grade of the cells in a tissue sample may be grade 3 cells, followed by grade 4 cells. The Gleason score for this sample would be 7.

What should your PSA number be?

The following are some general guidelines to help you understand your PSA test results: 0 to 2.5 ng/mL is considered safe. 2.6 to 4 ng/mL is safe in most men but talk with your doctor about other risk factors. 4.0 to 10.0 ng/mL is suspicious and might suggest the possibility of prostate cancer.

Is Gleason score same as PSA?

The PSA level at the time of diagnosis. The Grade Group (based on the Gleason score), which is a measure of how likely the cancer is to grow and spread quickly. This is determined by the results of the prostate biopsy (or surgery).

Is Gleason 7 serious?

A Gleason score of 7 is a medium-grade cancer, and a score of 8, 9, or 10 is a high-grade cancer. A lower-grade cancer grows more slowly and is less likely to spread than a high-grade cancer. Doctors look at the Gleason score in addition to stage to help plan treatment.

How reliable is Gleason score?

Overall accuracy was 58.3%. Both, biopsy and prostatectomy Gleason score correlated significantly with disease free survival (P = 0.001), furthermore the classification (Gleason scores < 7, 7 and > 7) was highly significant (P = 0.001).

How often are Gleason scores wrong?

In 29% of cases, high biopsy scores are downgraded to 7 or less after radical surgery, study finds.

What does a Gleason score of 3 3 6 mean?

Any other sixes you roll -- 4+2, 5+1 -- are losers. Gleason 3+3 is a hard six in prostate cancer. It is the lowest grade cancer in the traditional Gleason scoring system. Still, to the eye of a pathologist, a Gleason 6 looks like a malignancy. Now, a few experts are questioning whether this hard six is a cancer at all.

How long can you live with a Gleason score of 9?

PBI combined with EBRT has excellent 15-year survival in men with GS 9-10 and clinical stage ≤ T2a. While 68% of men with T3 GS9-10 are alive at 10 years, at 15-year survival was 0. These men should be considered for alternate treatment strategies, possibly with early systemic therapy.

What is a high risk Gleason score?

High risk. A Gleason score of 8 or higher, accompanied by a PSA level of higher than 20 ng/ml and a more advanced tumor stage, signifies a high risk of advancing cancer. In high-risk cases, the prostate cancer tissue looks very different from normal tissue.

Is a Gleason score of 9 treatable?

We showed that radiation-based treatments and surgery, with contemporary standards, offer equivalent survival for patients with very aggressive cancers (defined as Gleason score 9-10).

What is the life expectancy after prostate radiation?

Based on the natural history of localized prostate cancer, the life expectancy (LE) of men treated with either radical prostatectomy (RP) or definitive external-beam radiotherapy (EBRT) should exceed 10 years.

At what age is prostate surgery not recommended?

Radical prostatectomy is the preferred treatment for men with prostate cancer that has not spread to other organs, but many doctors do not recommend the procedure for men over age 70 due to a perceived higher potential risk for complications.