I need a Gleason score – should I be worried?

November 12, 2012

I need a Gleason score – should I be worried?

If you need a Gleason score, your doctor may want to test the health of your prostate.

If you have been told by your doctor that you need a Gleason score you are probably wondering what exactly it is. The Gleason score is a diagnostic tool used by doctors to determine and evaluate the prognosis of prostate cancer – its’ severity as well as the overall health of the prostate. A Gleason score will be useful in determining management options and the likelihood of a cure in the case of prostate cancer. The first stage of finding this score is to take a biopsy – this is done by removing a small piece of prostate tissue via the rectum, the sample is then used to prepare the slides used by the pathologist in diagnosis.

Accuracy is key

Accurate assessment and classification is essential when investigating prostate problems. The prostate is a gland, about the size of a walnut, located near the bladder – this means you will need to see an urologist if you are experiencing prostate problems. Once a biopsy has been taken the pathologist and urologist will work together, using the Gleason Score, to decide treatment program.

How the scoring works

The Gleason score is based upon tumor patterns measured during the prostate biopsy. The pathologist will read the transparencies with extreme accuracy and compare them to the control scores of a tumor – any misinterpretation of the result can mean a faulty analysis. Clearly there are limitations to this scoring system – different pathologists may see things slightly differently and not all pathologists have the same knowledge of the Gleason score system. If the biopsy has been a minor needle procedure then the specimen provided may not be a precise account of the tumor.

The Gleason score will be between 2 and 10 – where 10 indicates the worst outcome. Once, following biopsy, the two most common tumor patterns have been found they are given a Gleason grade of between 1 and 5 and these grades are added to give the Gleason score. A score of 6 or less indicates a low level risk of the cancer spreading. A score of 7 means the chance of the cancer spreading to other areas of the body is considerable and a score of more than 7 means that the cancer is likely to spread.

After the score

Once the patient’s Gleason score has been found a treatment program will be determined – treatments vary from keeping an eye on things to chemotherapy, radiotherapy, cryosurgery, hormone treatment to name a few.

Clearly the increasing grade indicates a poorer diagnosis, the Gleason system is currently the most popular scoring system for prostate cancer although alternatives are being researched.

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