If you had a prostate biopsy because cancer is suspected, one of the results in the report is the Gleason score. You may also see a grade listed in the report based on the Gleason score. The Gleason score helps your oncologist understand how aggressively the cancer is growing, so they can plan the right treatments and timing of treatment for each patient.
If you haven’t spoken with an oncologist after a prostate biopsy shows cancer, it’s a good idea to schedule an appointment at Blue Ridge Cancer Care. Our team will review your treatment options, which do not always include surgery to remove the prostate.
How Is the Gleason Score Determined?
During the prostate biopsy, several cell samples were gathered. They were then studied under a microscope to see how closely the cancer cells resemble normal prostate tissue. The two most predominant cell patterns in the samples will be assigned a score from 1 to 5, with 1 indicating normal cells and 5 indicating the cells are very different from normal prostate cells.
These two numbers are added together to create the Gleason score. A score less than 6 indicates that cancer is not present.
Gleason Score 6
A Gleason score of 6 means the cancer cells look more similar to normal prostate tissue than higher scores. These cancers are typically slow-growing and are considered the least aggressive form of prostate cancer. In many cases, watchful waiting may be an appropriate option, giving you time to review treatment options before you need to take action.
Gleason Score 7
A Gleason score of 7 falls in the intermediate range, but the order of the numbers makes an important difference.
When the score is 3 + 4 = 7, most of the tumor is made up of pattern 3 cells, with a smaller portion showing pattern 4. These cancers often behave more like lower-risk tumors and may grow more slowly.
When the score is 4 + 3 = 7, most of the tumor is composed of pattern 4 cells. These cancers are more likely to grow and spread compared to 3 + 4 tumors, even though the total score is the same. Your oncologist may recommend treatment start in the near future for those with a score of 4+3.
Gleason Scores 8–10
Gleason scores between 8 and 10 indicate that the cancer cells look very abnormal under the microscope. These cancers are considered aggressive and have a higher likelihood of growing quickly or spreading beyond the prostate. Treatment will begin right away for these patients.
Prostate Cancer Grades Based on the Gleason Score
The Gleason score may be transferred into a grade of cancer. The higher the grade the more likely it is to grow and spread.
- Grade Group 1: Gleason score 6
- Grade Group 2: Gleason 3 + 4 = 7
- Grade Group 3: Gleason 4 + 3 = 7
- Grade Group 4: Gleason score 8
- Grade Group 5: Gleason scores 9–10
The Gleason Score Is Part of the Bigger Picture for Prostate Cancer Treatment Planning
While the Gleason score is one of the strongest indicators of prostate cancer behavior, it is not the only factor your oncologist considers. They will review your PSA scores and the size of the cancer growth to determine the right timing for treatment and which treatments will be most effective. This is referred to as the cancer’s stage.
The medical oncology and radiation oncology doctors at Blue Ridge Cancer Care work together to review all of the results and, when the time is right, create a treatment plan for each patient. Request an appointment at one of our Southwest Virginia locations including Roanoke, Pulaski, Allegheny, Rocky Mount, Wytheville, Blacksburg, and others in the region.
