What is the gleason score and what is it used for?

Gleason grades where created by Dr. Donald Gleason in 1966. His discovery of how the progressions of cancerous prostrate cells grow. Armed with this information he was able to create a scale to guide other pathologist in determining growth patterns and their meaning. It is universally recognized as a grading system for prostate cancer. The larger the Gleason Grade the grouping becomes more irregular in shape and size the cells will appear.

Before the process gets this, far the doctor will first perform a DRE (digital rectal exam), which is when the doctor inserts his finger into your rectum and palpates the prostate to see if it is inflamed. This should be done yearly in men over the age of 40. The physician will then run a PSA (Prostate Specific Antigen) blood test that determines if the prostrate is excreting a high amount of this antigen that would indicate prostrate cancer. If all tests are negative the likely hood of having a biopsy are very slim.

If your level is under four this is within normal range. If the level were above four the findings would then be consistent in ordering an ultrasound. Prostrate ultrasounds are similar to a biopsy; although the probe is much smaller and the discomfort is minimal, it sends ultrasonic waves that take a picture of the prostrate to see if you warrant a biopsy.

The needle biopsy procedure means the doctor will use a probe in the rectum to the prostrate and removes tissue samples with a needle from the prostrate itself. There will be several samples taken. These samples are used to determine your GG (Gleason Grade).

The Gleason grade is a way the doctors and pathologists grade prostrate cancer cell progression. They first take two biopsies of the largest areas of the tumor; slice it into sections so it can be viewed under the microscope. Then the pathologist will grade the tumor sections by using a scale of 1 to 5. Prostrate cancer Gleason grade of one being the least assertive and five being the most aggressive.

The pathologist then takes the grades from both sections of the tumor and adds them together giving you a GG (Gleason Grade). An example would be tumor section one was a grade 1 and tumor section two grades at 3, they are then added 1+3 = GG 4. Some people become confused when they hear grades more than five. You must remember it is the combination of two separate parts of a cancerous tumor. The primary and the secondary numbers with two separate grades as mentioned above.

How the Gleason grades relate to you and your situation.

• A Gleason grade of 1-2 is rare, the cancer simulates a normal prostate, which is not widely diagnosed except by means of a PSA blood test that would be elevated. In this event, a physician would recheck with needle biopsies of the area every three months.

• A Gleason grade of 2-4 is low aggressive cancer of the prostate.

• A Gleason grade of 5-6 is mildly aggressive.

• Gleason grades of 7-10 are indicators that it is an aggressive cancer, at this point the doctor will talk to you about prognosis and options.

It is important to remember that there are exceptions to every rule. Some men who have a high Gleason grade may do very well with treatment and recovery. Other men that have a low Gleason grade may not do well at all. In medicine, there are no guarantees, and each person’s body fights off disease processes in different ways.

Men often find comfort talking with other men suffering from the same disease. There are several online resources, forums, and chat groups to help with coping and understanding the disease. It is not a death sentence, a positive outlook, strong emotional health, and following your doctor’s advice increases your chances of doing well.