What is a Gleason Score?

After the biopsy of your prostate cancer, your doctor will explain the results to you using something called a Gleason Score. This grading system was devised in the 1960’s by a pathologist named Donald Gleason who realized that cancerous cells fall into 5 distinct patterns as they change from normal cells to tumor cells. The cells are scored on a scale of 1 to 5. Those cells closest to 1 are considered to be “Low-grade” tumor cells and tend to look similar to normal cells. Cells closest to 5 are considered “High-grade” and have mutated so much that they barely resemble normal cells.

How is Gleason Score derived?

The pathologist looking at the biopsy sample will assign one Gleason grade to the most predominant pattern in your biopsy and a second Gleason grade to the second most predominant pattern. For example: 3 +4. The two grades will then be added together to determine your Gleason score (between 2 and 10).

What Does it Mean?

Generally speaking, cancers with lower Gleason scores (2 – 4) tend to be less aggressive, while cancers with higher Gleason scores (7 – 10) tend to be more aggressive.

It’s also important to know whether any Gleason 5 is present, even in just a small amount, and most pathologists will report this. Having any Gleason 5 in your biopsy or prostate puts you at a higher risk of recurrence.

How Will this Affect my Treatment Plan?

The lower your Gleason Score, the more likely it is that your doctor will recommend Active Surveillance. However, your doctor will take your Gleason Score as well as many other factors into consideration when determining a treatment plan.

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