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What is a Gleason Score?

  • Posted On:
  • Written By: Brad Lake, MD

You might think the Gleason Score has something to do with the former Saints safety, but you’d be wrong.

The Gleason Score is a grading system used to determine the aggressiveness of prostate cancer, and is used to determine treatment options.

Grading and staging define the progress of cancer and whether it has spread. The grade is a measure of how quickly the cells are likely to spread and grow. The most common grading system is the Gleason Score, named for the pathologist who conceived the system in the 1960s.

The Gleason Score grades each tissue piece is given a grade on a scale of 1 to 5. Grade 1 cells indicate normal tissue while cells closest to 5 are considered “high-grade” and have changed so much that they barely resemble normal cells. Most cancers score a grade of 3 or higher.

Because prostate tumors are often made up of cancerous cells with different grades, two grades are assigned for each patient – a primary grade for the cells that make up the tumor’s largest area and a secondary grade for the cells of the next largest area. For example, if the Gleason Score is 3+4=7, it means most of the tumor is grade 3 and the next largest section is grade 4 for a total Gleason Score of 7.

Most Gleason Scores range from 6 to 10. The higher the score, the more likely the cancer will grow and spread quickly.

  • Scores lower than 6 describe cancer cells that look similar to normal cells and indicate that the cancer is growing slowly.
  • Scores of 7 indicate an intermediate risk for aggressive cancer. Scoring a 7 means that the primary score was 3 or 4. Tumors with a primary score of 3 and a secondary score of 4 have a positive outlook. Cancers with a primary Gleason Score of 4 and secondary score of 3 are more likely to grow and spread.
  • Scores of 8 or higher refer to cancers that are likely to spread rapidly.

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