Advanced Prostate
Cancer
The Gleason Score
Prostate cancer is the second most deadly form of cancer in males next to lung
cancer. It can strike men in their fifties and may not be detected until it’s
too late. A Gleason Score was developed to help evaluate the stages of prostate
cancer and to determine prognosis and to guide therapy.
A Gleason Score is given to grade prostate cancer. The scale numbers from 1-5.
The Gleason Score numbers from 2-10. The lower the score, the better prognosis,
the higher score means the cancer is more aggressive and the prognosis is worse.
The Gleason Score was named after Donald F. Gleason, M.D. who was a pathologist
at the Minneapolis V.A. Hospital. It was developed in the 1960’s to help
determine the level of cancerous cells present after a biopsy.
To determine the grade of prostate cancer a urologist will take a biopsy of
prostate tissue through the rectum, it will then be prepared for examination by
a pathologist. They will give the biopsy a grade.
Grade 1: cells are close together and resemble normal prostate tissue
Grade 2: cells are larger and have more space between them.
Grade 3: cells are darker but have left the glands and are beginning to surround
other tissue.
Grade 4: cells have left the glands but are still recognizable; they are
surrounding and invading other tissue.
Grade 5: cells are unrecognizable and have sheets of cancerous cells throughout
the surrounding tissue.
A Gleason Score is the combination of two patterns, the cell tissue and the
cancerous tissue. The grades are added to the score to determine the proper
course of treatment which could range from chemotherapy to surgery. Prostate
cancer is metastasizing cells, which means in can invade other parts of the body
such as the bladder, bones and rectum.
Early detection is always the key and many men over fifty should get a checkup
to determine if any cancerous cells have developed.