Decoding Your Gleason Score: What It Means for Your Prostate Cancer Diagnosis
By Dr. David Samadi
If you’ve been diagnosed with prostate cancer, one of the first questions on your mind might be, What’s my prognosis, and what are my treatment options? That’s where the Gleason score comes in. This key number helps your doctor understand how aggressive your cancer is and guides the treatment plan.
Let’s break it down in a way that’s easy to follow.
What is a Gleason Score?
The Gleason score has been the go-to grading system for prostate cancer since Dr. Donald Gleason developed it in 1966. Essentially, it measures how abnormal—or aggressive—the cancer cells look under a microscope.
When a biopsy is performed, A thin needle is used to extract small samples of prostate tissue. These tissue samples, called cores, are then examined by a pathologist, who assigns a Gleason score based on the cancer’s appearance.
How is the Score Calculated?
The Gleason score is made up of two grades:
- Primary grade: The most common pattern of cancer cells in the tissue.
- Secondary grade: The second most common pattern.
Each grade is scored on a scale of 1 to 5:
- 1: The cells look almost like normal prostate tissue.
- 5: The cells are highly abnormal and aggressive.
The two grades are then added together to get a Gleason score ranging from 2 to 10.
What Your Gleason Score Means
Here’s a simple way to interpret your score:
- Low (2–4): These are well-differentiated cells, which still resemble normal tissue. This type of cancer is usually slow-growing and may not require immediate treatment. Active surveillance is often recommended.
- Intermediate (5–7): Most prostate cancers fall into this category. The cells are moderately abnormal, and the tumor has the potential to grow or spread over time. Treatment options might include surgery or radiation, depending on your age and overall health.
- High (8–10): These poorly differentiated cells indicate an aggressive cancer that may increase or have already started to spread. Treatment often involves surgery and may include radiation if needed.
Why Your Gleason Score Matters
The Gleason score is a critical piece of the puzzle, but it’s not the only factor your doctor will consider. Other important details include:
- The how many of the biopsy samples that contain cancer.
- The percentage of cancer in each sample.
- Whether the tumor is found on one or both sides of the prostate.
What’s Next?
Once your Gleason score and other biopsy results come back, you will sit down with your doctor to discuss the best path forward. Options may range from active surveillance for low-risk cancers to surgery or radiation for more advanced cases. Regular follow-up tests, such as PSA levels or repeat biopsies, help monitor your progress and ensure the cancer stays under control.
Final Thoughts
Understanding your Gleason score can initially feel overwhelming, but it’s essential in tailoring your treatment plan. By knowing what your score means, you’ll be better equipped to make informed decisions and take an active role in managing your health.
If you have questions or concerns, don’t hesitate to ask your doctor—they’re there to guide you every step of the way.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of Prostate Cancer, Now What? and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911.