If you or a loved one has recently been diagnosed with Prostate Cancer, you’ve likely been introduced to a lot of new medical terms. One of the most important is the Gleason score.
Understanding What is a Gleason Score is a critical first step in making sense of your diagnosis and planning your path forward. While it might sound complex, the Gleason score is simply a tool to understand the nature of the cancer.
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What is a Gleason Score?
A Gleason score is the most common system used to grade the aggressiveness of prostate cancer. After a biopsy, a pathologist examines the cancer cells under a microscope and assigns a grade from 1 to 5 based on how abnormal the cells look compared to healthy tissue.
Think of the Gleason score as a “report card” or an “aggressiveness rating” for prostate cancer. It is determined by a pathologist who examines the tissue samples from your prostate biopsy under a microscope. Its main purpose is to grade how aggressive the cancer cells appear, which helps predict how likely the cancer is to grow and spread.
How is the Gleason Score calculated?
To get the Gleason score, the pathologist assigns two numbers based on the appearance of the cancer cells. These two grades are added together to create your final Gleason score.
- The Primary Grade (First Number): This is the grade (from 1 to 5) given to the most common cell pattern found in your biopsy sample.
- The Secondary Grade (Second Number): This is the grade given to the second most common cell pattern.
For example, if the most common pattern is Grade 3 and the second most common is Grade 4, your score is written as 3+4=7.
What the Numbers in Gleason score Mean?
The final Gleason score helps categorise the cancer’s aggressiveness. Here’s a clear breakdown of the Gleason score chart.
- Gleason Score 6 (Grade Group 1): Low-Grade Cancer
A Gleason score of 6 is the lowest score you can have from a biopsy. It is considered low-grade, meaning the cancer cells look very similar to normal prostate cells. This type of cancer is typically slow-growing and less likely to spread. For many men in this category, “active surveillance” may be a recommended option.
Understand the different types of Prostate Cancer.
- Gleason Score 7 (Grade Group 2 & 3): Intermediate-Grade Cancer
This is the most common score. A Gleason score of 7 indicates an intermediate risk. However, there’s an important distinction:
- Gleason 3+4=7: This is less aggressive because the primary, most common pattern is a lower grade.
- Gleason 4+3=7: This is considered more aggressive because the dominant cell pattern is a higher grade.
- Your doctor will consider this difference when discussing your treatment options. Difficulty in finding doctor?
- Gleason Scores 8, 9, and 10 (Grade Group 4 & 5): High-Grade Cancer
A Gleason score of 8, 9, or 10 indicates a high-grade, aggressive prostate cancer. The cancer cells are poorly differentiated, meaning they look very different from healthy cells. This cancer is more likely to grow quickly and spread, so treatment is usually recommended.
What is the Gleason Grade Group System?
To make things even clearer, the medical community now also uses a newer system called Gleason Grade Groups, which simplifies the scores into five categories.
- Grade Group 1 = Gleason Score 6
- Grade Group 2 = Gleason Score 7 (3+4)
- Grade Group 3 = Gleason Score 7 (4+3)
- Grade Group 4 = Gleason Score 8
- Grade Group 5 = Gleason Scores 9 and 10
This system makes it easier to understand the cancer’s potential aggressiveness at a glance.
Why is Gleason Score a Critical Part of Diagnosis?
Gleason score is a crucial tool that directly influences the patient’s treatment plan.
- A low score might mean you can safely monitor the cancer without immediate treatment.
- A high score might point towards the need for more immediate and definitive treatment, such as surgery or radiation.
Conclusion
In conclusion, understanding what is a Gleason Score and your Gleason score is the very first step in your prostate cancer journey. It transforms a complex diagnosis into clear, actionable information. Use this knowledge to have a detailed and confident conversation with your urologist about the best path forward for your specific situation.
It’s important to remember that the Gleason score is just one part of the picture. Your doctor will make a final recommendation based on your score, your Prostate-Specific Antigen (PSA) level, the cancer stage, and your overall age and health.
FAQs
1. Is a Gleason score of 6 considered serious?
A Gleason score of 6 is considered low-grade cancer. While it is still cancer and needs to be monitored, it is the least aggressive form and often grows very slowly.
2. Which is worse, a Gleason score of 3+4 or 4+3?
A Gleason score of 4+3 = 7 is considered more aggressive than a 3+4 = 7. This is because the primary, or most dominant, pattern of cancer cells is the more aggressive Grade 4.
3. Can my Gleason score change over time?
Yes. If you are on active surveillance and have a follow-up biopsy, the score could change if a more aggressive pattern of cancer has developed or is found in a different area of the prostate.
