Prostate Cancer Gleason Score: What to Know

The prostate is a walnut-sized gland of the male reproductive system that sits just below the bladder. It is responsible for secreting seminal fluid that protects sperm.

If you are a male aged 50 or older, you have an increased risk for prostate cancer. If your doctor finds any size or shape abnormalities at your annual physical exam, he may recommend further prostate screening.

What is the prostate cancer Gleason score?

If your doctor recommends a prostate biopsy, your pathology report will include a prostate cancer Gleason score. Doctors typically take several samples during the biopsy and each sample will have it’s own grade. Cell samples are graded from one to five; a grade five means the cells have mutated and no longer resemble normal cells.

A pathologist will assign one grade to the most predominant cell pattern in your biopsy samples, and a second grade to your second most predominant cell pattern. When these results are presented on your pathology report, however, they are added together, which may be confusing.

For example, you may see 3+4=7 or 4+3=7 on your pathology report. The first number in the equation indicates the predominant cell pattern in your tumor. If you see a 4+3=7 on your report, it means your cancer is more advanced than a 3+4=7. This distinction is very important for understanding the severity of your tumor. To help people better understand their prostate cancer Gleason score grade groups were developed.

What are grade groups?

The Gleason grading system does not adequately differentiate between similar groups. For example, a Gleason score of seven can be the result of 3+4 or 4+3, with the latter having a worse prognosis. Therefore grade groups were developed to help people understand their prostate cancer Gleason score as it relates to the severity of their prostate cancer:

  • Grade Group 1 = Gleason 6 (or less)
  • Grade Group 2 = Gleason 3+4=7
  • Grade Group 3 = Gleason 4+3=7
  • Grade Group 4 = Gleason 8
  • Grade Group 5 = Gleason 9-10

Typically, cancers with Gleason scores of two, three or four are less aggressive, while cancers with higher Gleason scores are more aggressive.

The reason these scores are presented side by side with their grade groups is because it is vitally important to know if any Gleason score of five is present—even in a small amount. Having any Gleason five scores in your biopsy or prostate puts you at a higher risk of recurrence.

If you or a loved on is in need of expert prostate cancer treatment in Tinley Park, Homewood and Palos Heights, Illinois, please contact Alpha Med Physicians Group at 708-928-5040 to schedule an appointment. Our physicians are highly skilled in the diagnosis and treatment of prostate cancer and want to help you live your best life.