Gleason Score

November 12, 2012

Gleason Score

Prostate cancer is a form of cancer that originates in the prostate, a small walnut-sized gland that is a part of the male reproductive tract. Gleason score is used in the diagnosis of prostate cancer to estimate the spread of the disease.

Salient Features

Prostate cancer is the most common cancer in men over the age of 75 years. The condition is rarely seen in men under the age of 40. African-American men, painters, tire-plant workers and farmers are at a greater risk of getting prostate cancer. The common symptoms of the disease include delayed or slow urinary flow, blood in urine or semen, and bone pain. Complete rectal examination along with histo-pathological analysis of the prostate sample will confirm the diagnosis of the disease.


The PSA, or mean prostate specific antigen, is a protein made by the prostate gland. While this is not universally accepted, many doctors believe that the PSA levels in the blood will indicate the spread of prostate cancer. In fact, prostate seed brachytherapy is only useful in patients with a PSA value of less than 10.

Gleason Score

Understanding the Gleason score is important to understand the severity of prostate cancer. The score tells how fast the cancer will spread. This is your first line of defense against the disease. It will help you plan your treatment strategy along with your oncologist.

The Gleason score is determined by a pathologist as he or she observes your biopsy sample under the microscope. The score consists of two main components – The “big picture” or the overall pattern and the more specific “forest of trees.” A biopsy showing a major pattern of 3 and a minor pattern of 3 has an overall score of 6. High Gleason scores indicate increased risk of the cancer spreading to other parts of the body through the blood and reduced chance of curability through radiation therapy.

  • Scores 2 – 5: Low-grade prostate cancer
  • Scores 6 – 7: Intermediate- (or in the middle-) grade cancer. Most prostate cancers fall into this group.
  • Scores 8 – 10: High-grade cancer


The final number of Gleason score can help predict the stage of the disease and the chance of cure. Apart from digital rectal examination, radiographic evaluation of the nearby lymph nodes as well as bone scans may indicate the spread of the disease. The Gleason score and other factors help categorize the disease into four stages. Staging helps predict prognosis. While stage IV cancers indicate extensive spread, stage I cancers are rare and may not require any treatment. Regular screening and therapy can help cure the cancer completely.

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