Gleason Score

What is a Gleason Score?

The Gleason score is a grading system used to evaluate the aggressiveness of prostate cancer. It is determined by examining prostate tissue samples under a microscope to assess the patterns of cancer cells. The score helps predict the behavior of prostate cancer, including how quickly it is likely to grow and spread, thereby guiding treatment decisions.

 

Understanding the Gleason Score

Dr. Donald Gleason developed this system in the 1960s, and it remains a critical tool in prostate cancer diagnosis and management. The scoring process involves two components: the most common (primary) and the second most common (secondary) patterns of cancer cells observed. Each pattern is assigned a grade from 1 to 5, with 1 representing cells closely resembling normal prostate tissue and 5 representing highly abnormal cells.

To calculate the Gleason score, the grades of the primary and secondary patterns are added together. Therefore, the score ranges from 2 to 10. However, scores below 6 are rare since grades 1 and 2 are generally not used due to their similarity to benign conditions. Consequently, the practical Gleason scores typically range from 6 to 10.

• A Gleason score of 6 (3+3) indicates low-grade cancer, meaning the cells are well-differentiated and less likely to spread.
• A score of 7 can be either 3+4 or 4+3, with the latter indicating a more aggressive cancer due to the higher proportion of grade 4 cells.
• Scores of 8 to 10 indicate high-grade cancer, with poorly differentiated cells and a higher likelihood of rapid growth and metastasis.

Understanding the Gleason score is crucial for both patients and healthcare providers. It informs the choice of treatment options, which may range from active surveillance for low-risk cases to surgery, radiation, or hormone therapy for more aggressive forms of prostate cancer.