My PSA was 19 with Gleason 7, and I was promised a cure. You have time to … New Grading System. Up-grading at prostatectomy was observed in 15.9% of biopsy Gleason score 3+4=7 cases and 11.5% of biopsy Gleason score 4+3=7 cases. For example, if the pathologist only saw Gleason 3, then the Gleason score would be 6 (3+3). The pathologist will give a grade for each pattern of prostate cancer cells found in the biopsy. i'm not sure if i caught it early, or if whatever treatment i choose will be right for ME here is some pathology information and below is the letter that was emailed to me from the staff. 286 of these men started with a Gleason score of 3 + 3 = 6. And this, by itself, depends on a good initial diagnosis and on the choice of therapy. Prostate cancer with Gleason score 7 from 4+3 had worse overall survival and cancer-specific survival than Gleason score 7 from 3+4 20). Mortality rates for Gleason scores of 3+4 are similar to Gleason 3+3 scores while Gleason 4+3 are similar to the more aggressive Gleason 8 scores. This is considered early-stage prostate cancer and may not progress further or may progress slowly. Gleason 3+4 does not equal immediate active treatment. HISTOLOGIC GRADE: Gleason score 6 (3 + 3). We found a significantly higher risk of PC-specific mortality and all-cause mortality among men with GS 3+5 or 5+3 compared to GS 4+4 PC, … Redefined in 2005, Gleason Score no longer consists of only 3 grades, from 3 to 5. 73 men started with a Gleason score of 3 + 4 = 7; 147/359 men (40.9 percent) went on to have some form of treatment. Most prostate cancers have a Gleason pattern of 3, 4 or 5. OVERTREATMENT. When a biopsy confirms the presence of cancer, the next step is to determine the level of aggressiveness (grade) of the cancer cells. The predominant grade seen in a needle core is the first number of the Gleason score. As a rule of thumb, the lower the Gleason score, the less severe the condition is, and more of surveillance rather than active treatments would be recommended. Grade group. While the stage of your cancer looks at where the cancer is present in your body (how it is behaving at the macro level), the grade describes what the actual cancer cells look like under a microscope (how they are behaving on a micro level). Gleason 8 and above will need treatment and treatment options might include surgery, radiotherapy, cryosurgery, hormone therapy, chemotherapy and immunotherapy. Gleason Score of 7. Group 1: A Gleason score of 6 (3+3=6) or less. The rate of newly diagnosed patients with Gleason 3+3 (Grade Group 1) prostate cancer (PCa) who choose go on Active Surveillance (AS) instead of immediate treatment has increased significantly in the last decade. It is the most important measurement in a pathology report. I have been struck in the past few weeks by the number of patients in my practice who have advanced metastatic CRPC who were diagnosed more than 15 years ago and had, on their original biopsy specimen, ONLY a Gleason 6 pattern prostate carcinoma. – Grade Group 1 = Gleason score ≤ 6 – Grade Group 2 = Gleason score 3 + 4 = 7 – Grade Group 3 = Gleason score 4 + 3 = 7 – Grade Group 4 = Gleason score 8 – Grade Group 5 = Gleason scores … Rarely do oncologists assign a Gleason Score below 6. Treatment options for Gleason score 4+3. Gleason score 8 disease represents a heterogeneous entity with PCSM outcomes distinguishable by the primary Gleason pattern. Nearly 250,000 will be diagnosed this year. Results Among Gleason score 8 cancers the cancer status outcome in 51 men with Gleason score 3 + 5 = 8 was marginally worse than in 114 with Gleason score 4 + 4 = 8 (p = 0.04). What does it mean when there are different core samples with different Gleason scores? In 2005, Gleason scores of 5 or less were no longer considered carcinoma and, by redefining certain pathological features previously assigned to the Gleason pattern 3, were now assigned to patterns 4 or 5. Indeed, two cases can produce this score: Gleason score 3+4 or 4+3. The Gleason Score ranges from 1-5 and describes how much the cancer from a biopsy looks like healthy tissue (lower score) or abnormal tissue (higher score). How is it determined? Their Gleason score may be either a 3 + 4 = 7 or 4 + 3 = 7. The cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. A higher grade indicates a more aggressive cancer that … Gleason patterns (Grade 5 is the most aggressive) ISUP Grading – Grade Group 3 = Gleason score 4 + 3 = 7 – Grade Group 4 = Gleason score 8 – Grade Group 5 = Gleason scores 9 and 10 : New Grading System - Initial Data from John Hopkins • 7869 men undergoing RP without tertiary pattern since 2004 • Median follow-up of 2 years (1-7 yrs range) Gleason score 3+3=6 (Grade Group 1)]. When this was confined to men with T1/T2 disease, the reduction in the proportion of men with a Gleason score of ≥ 8 was only 19.5% to 16%. Where is it located? 117 of the men who went on to have treatment elected to have a radical prostatectomy 77/117 men were in Group A; 40/117 men were in Group B These groupings are not entirely accurate, since a Gleason score of 7 is made up of two grades: 3 + 4 and 4 + 3. To avoid confusion, it will be prudent to report the new grading system, in conjunction with the Gleason system, until it becomes widely accepted and practiced [ie. When it comes to Gleason scores of 6, (3+3=6) and Gleason scores of (3+4=7), many oncologists do not feel that treatment is beneficial. If you have 3 or fewer cores positive and those cores are less than 50% tumor, then you meet the strict requirements for Johns Hopkins Active Surveillance protocol. Prostate cancer is the most common solid male organ cancer in the US. Also, Gleason scores of 9 or 10 have a worse outlook than a Gleason score … Grade Group 5 (Gleason scores 9 and 10). • Five distinct Grade Groups based on the modified Gleason score groups. Treatment options at stage 2 include: removing your prostate and … based on my research on articles from Major institutions and the points of view from AS and NV, I would be selecting AS as my treatment. Therefore, if we go back to our example, 3 and 4 would be added together for a sum of 7. The consultant will give you a total score out of 10, which should be split down as two numbers out of 5: for example, 4+3. A symptom is an indication of disease, illness, trauma, or that something is not right in their own bodies. CORES INVOLVED: 3/4. Can a Gleason score of 3+3=6 and 3+4=7 recur? If a Gleason score is written in your pathology report as 3+4=7, this means most of your tumor is grade 3 and less of it is grade 4. These numbers are then added together for a total Gleason score of 7. Grades 1 and 2 are not usually used to describe cancer —these grades are for tissue that almost looks normal and isn't considered cancerous. The Gleason Score is the grading system used to determine the aggressiveness of prostate cancer. Also, both in the literature and for therapeutic purposes, various scores have been incorrectly grouped together with the assumption that they have a similar prognosis. Posts: 17 Joined: Mar 2013 Mar 17, 2014 - 12:20 pm. The highest Gleason score is 10 (5+5) and the lowest is 2 (1+1). HISTOLOGIC TYPE: Adenocarcinoma, conventional type. Gleason score: Description: 6 (3+3) All the cancer cells found in the sample are representative for grade 3 and exhibit a slow growth. For Gleason score 7 (3+4=7 or 4+3=7), treatment options are often individualised because of the different severity levels (where Gleason score 3+4=7 is less severe). The International Society of Urological Pathology recommends that Gleason score (GS) 8 prostate cancer (PC) is one prognostic category, yet heterogeneity in cancer control potentially exists amongst men with GS 3 + 5/5 + 3 versus GS 4 + 4 PC.We compared PC-specific mortality (PCSM) and all-cause mortality (ACM) risk among men with GS 3 + 5/5 + 3 versus GS 4 + 4 PC using competing … 729,730 Among patients with Gleason score 7, primary grade 4 indicates a likelihood of higher tumor stage and higher probability of PSA recurrence after surgery than primary pattern 3. If you have a high Gleason score, are younger or have higher stage disease, your urologist is more likely to suggest you have active treatment. One tool that doctors use to describe the stage is the TNM system. The grade of a cancer tells you how much the cancer cells look like normal cells. i'm a 45 yr. old black male who was diagnosed with PCa gleason 4+3=7. The proportion of patients with a Gleason score of ≥ 8, however, decreased far more modestly, from 25.3% to 17.6%. TOTAL TISSUE … Because of modern biopsy techniques, grades of 1 and 2 are rarely used, so the lowest Gleason score likely to be reported is Gleason 6. Based on the current knowledge we can identify patients with Gleason score 3+4 prostate cancer that has a low risk of experiencing progression when not actively treated. On the average doctors expect patients to become resistant within two to three years on ADT alone. Whereas, Gleason grades 4 and 5 are considered high risk. Prostate Cancer Treatment Options. 18 However, studies that have specifically assessed differences in Gleason 3 + 4 and 4 + 3 … A contemporary prostate cancer grading system: A validated alternative to the Gleason score. A Gleason score is given to prostate cancer based upon its microscopic appearance. (Please note that this link takes you to a different website.) The grade of the cancer corresponds to the pattern number. A doctor in a lab examines a sample of your cancer cells to determine how much cancer cells differ from the healthy cells. These data are consistent with the literature supporting the concepts that on prostate biopsy: one, current Gleason score 6 tumors are more homogeneous and associated with better prognosis than in the past 7,26 because of reclassification of what was previously referred to as Gleason score 6 to Gleason score 7 today; two, as compared with Gleason score 3 + 4, Gleason score 4 + 3 … SUMMARY SYNOPTIC REPORT: Prostate cancer (core needle biopsy). For these men HIFU Focal Therapy is a viable alternative treatment. Objectives: Previous studies has shown that Gleason score (GS) 3+3 does not seem to metastasize or cause prostate cancer specific deaths. PSA 5, Gleason 7 is nothing to worry about. These two numbers are added together to determine the Gleason Score, which ranges from 2-10. Alternatively, treatment may require a more active approach such as radiation therapy, surgery or ultrasound. At least initially, the pathology report is one of the most important factors in the management of your prostate health, especially if you have been diagnosed with cancer. PSA level The PSA (Prostate Specific Antigen) test is used as a risk assessment for prostate cancer and is likely to be the reason for your referral for further tests. It also helps him to slow down in his research, and take the time he needs to make the treatment decision he really wants. It starts from 2 (1+1), written 1-1, to 10 (5+5) written 5-5. This arbitrary reclassification has resulted in an upgrading and an increase in the Gleason 7s category (3+4 and 4+3). The lowest Gleason score asigned today to a man who is found to have cancer cells in his prostate on biopsy is 6 (3 + 3). Why Is My Patient Dying If He Only Had a Gleason 3+3? My friend had Gleason score 4+3 on 2 cores with 20% & 85% involvement and Perineural invasion. In December my PSA had fallen to 0.1 after treatment. 2 The Gleason system, introduced in 1974, 3 is an architectural grading system that ranges from 1 (well differentiated) to 5 (poorly differentiated). Grade Group 2: Gleason Score 3 + 4 = 7 hello, good people. In the first example (3 + 4), there are more cells identified as a 3. According to Gleason’s methodology, level 7 cancers may not be aggressive, but may have the potential to be. The order of the individual Gleason scores is, therefore, significant since the first score is the most common pattern of prostate cancer cells. If you have prostate cancer, your Gleason score will be between 6 (3+3) and 10 (5+5). TOTAL CARCINOMA LENGTH: 18 mm in linear dimension. Using PCa mortality as the primary end point, we compared outcomes in Gleason 3 + 4 and 4 + 3 cancers, and the predictive ability of GS from a standardized review versus original scoring. Gleason score predicts how fast your prostate cancer is growing. For example, a patient may be assigned a 3 and a 4. Men in Grade Group 3 may need more treatment than men in Grade Group 2. Gleason graded according to microscopic appearance of cancer grades between 1-5. Gleason patterns 1 and 2 are not commonly used because these cells look a lot like normal cells. This system is developed by the American Joint Committee on Cancer. Interestingly, if two different patients have a Gleason score 7 cancer, and patient A’s is 3+4=7 and patient B’s is 4+3=7, even though they both have a Gleason score of 7, patient B’s disease is more aggressive because the primary grade was 4. Grade Group 3 or 4 (Gleason score 4+3=7 or 8) PSA less than 20. Published: March 10, 2009. Gleason score consists of two numbers called grades, which range from 1-5.Grade 1 indicates slow growth prostate cancer, and grade 5 is rapidly growing cancer. Rarely do oncologists assign a Gleason Score below 6. It might (or might not) be felt by digital rectal exam or seen with imaging such as transrectal ultrasound [T1 or T2]. The PCSM of Gleason score 3 + 5 = 8 and Gleason 4 + 4 = 8 disease are similar, but patients with Gleason score 5 + 3 = 8 have a risk of PCSM that is twice as high as other pat … Cleason scores are made up of the two most common patterns found in the tumor (for example Gleason score 7 could be made up of pattern 3 + pattern 4). As previously mentioned, the first number is indicative of cell appearance and aggressiveness. We have done numerous subset analyses of therapy with Abiraterone, for example, that show that higher Gleason score patients are more likely to experience drug resistance and death from the disease. Epstein grade groups will replace it. The Gleason score is very important in predicting the behavior of a prostate cancer and determining the best treatment options. Still, other factors are also important, such as: What are Grade Groups? Grade Groups are a new way to grade prostate cancer to address some of the issues with the Gleason grading system. 7 (3+4) The majority of cancer cells in the biopsy tissue exhibit a slow growth but there are also cells that have a moderate growth. Node (N):Has the tumor spread to the lymph nodes? Published 01 May 2017. i had an mri that found 3 lesions on my prostate. The Grade Group is 3 or 4. Thus grade4 + grade 3 gets a gleason score of 7. Gleason Grading System Sometimes, it can be hard to predict how well people will do based just on their Gleason scores alone. Each side is allocated a number 3 - 5 and these are added together. Grade Group 1: Gleason Score 3 + 3 = 6. (Thus, how can we possibly be cured if it cannot kill us in the first place?) One important component of staging your cancer is the gradeof the cancer. The aim of this study was to confirm these findings by investigating whether patients, who had undergone radical prostatectomy (RP) at Sahlgrenska University and were diagnosed with GS ≤ 3+3, have had biochemical recurrence (BCR). Cancers with a Gleason score of 7 can either be Gleason score 3+4=7 or Gleason score 4+3=7: Gleason score 3+4=7 tumors still have a good prognosis (outlook), although not as good as a Gleason score 6 tumor. 3 + 2 = 5 ). 1 being least malignant. If patients and caregivers think their Gleason of 3+3=6 is in the middle of the range of Gleason Scores, it becomes almost psychologically impossible to consider Active Surveillance, and not choose immediate treatment with surgery or radiation. Yes, it happens. A Gleason Score biopsy result greater than 7 can be an indication of intermediate or high risk prostate cancer. A Gleason score indicates the extent to which the appearance of a sample of prostate tumor cells departs from that of healthy cells in the prostate. The Higher the Gleason score, the more advanced and aggressive prostate cancer. Dramatically reducing the diagnosis and treatment of Gleason 6 disease is likely to have a favorable impact on the net benefit of prostate cancer screening. This means 7 would be the patient’s Gleason Score. Gleason scores ranging from 2 (1+1) to 5 (3+2) are regarded as unremarkable. This grading system can be used to choose appropriate treatment options. To find out the Gleason score or Grade Group, a pathologist looks at several samples of cells (biopsies) from your prostate. If your Gleason score is made up of two of the same Gleason grades, such as 3+3, this means that no other Gleason grade was seen in the samples. Also, Gleason scores of 9 or 10 have a worse outlook than a Gleason score … PATIENTS AND METHODS Three study pathologists conducted a blinded standardized review of 693 prostatectomy and 119 biopsy specimens to assign primary and secondary Gleason patterns. Doctors use the results from diagnostic tests and scans to answer these questions: 1. The cancer has not yet spread outside the prostate. 2. This is not a negligible percentage of all Gleason 3+4 patients. > OVERTREATMENT is treatment instituted for a disease that is unnecessary and unneeded. This means 7 would be the patient’s Gleason Score. Doctors have demonstrated that treating Gleason 3+3=6 and/or Gleason 3+4=7 is over treatment for 99.9% of men because: Essentially NO ONE (<.1%) dies from G3's. Calculating the Gleason score As a general guide, treatment options for men with Gleason score 6 (low-risk) prostate cancers include Active Surveillance (i.e. close monitoring), surgery, and radiation therapy. For Gleason score 7 (3+4=7 or 4+3=7), treatment options are often individualised because of the different severity levels (where Gleason score 3+4=7 is less severe). Reference: Table adapted from – Chan TY, Partin AW, Walsh PC, et al: Prognostic significance of Gleason score 3+4 versus Gleason score 4+3 tumor at radical prostatectomy. The Gleason 7 (3+4) behaves like a favorable-risk Gleason 6 (3+3) and men over 65 with low volume Gleason 7 (3+4) i.e. a small amount of grade 4, may NOT need treatment. Your doctor might also talk about your "grade group". This is your Gleason score and it describes the grade of your cancer. These data provide important information for counseling patients with Gleason 7 prostate cancer on the natural history of the disease and may inform treatment decisions. If so, where and how … the Gleason score will be 7 (3+4). The American Cancer Society notes two exceptions to the standard rule: If the highest grade takes 95 percent or more of the biopsy sample, the grade for that area is counted twice. PIVOT trial showed that monitoring and treatment have same survival at 12 years out, and likely forever. Gleason score 7 cancer is common and heterogeneous, perhaps because of the range of Gleason grade 4 patterns (fused, 75% prevalence of G4; ill-defined, 64%; cribriform, 48%; and glomeruloid, 25%). It is being replaced. Because numerous studies suggest that Gleason 3 + 4 tumors (ie, those where pattern 3 is most prevalent but some amount of pattern 4 is also observed) have a better prognosis than Gleason 4 + 3 tumors (ie, those where pattern 4 is more prevalent than pattern 3), contemporary clinical risk prediction now incorporates primary and secondary Gleason pattern. The first number is the predominant grade, so a score of 4+3=7, for example, is likely to prove slightly more aggressive than a score of 3+4=7. The Gleason Score reporting system will be phased out over the next few years as a newer prognostic grade group system is introduced. Gleason score 8 disease represents a heterogeneous entity with PCSM outcomes distinguishable by the primary Gleason pattern. There are complex technical reasons for this, and patients diagnosed before 2002 may have been assigned lower Gleason scores (e.g. Score is based on 3 rules: After biopsies analysis, when several tumor cells are different from the gland, Gleason score is then the sum of the two tumor cells group. It is the lowest grade cancer in the traditional Gleason scoring system. Mortality rates for Gleason scores of 3+4 are similar to Gleason 3+3 scores while Gleason 4+3 are similar to the more aggressive Gleason 8 scores. ... His gleason score is 7 (3/4). The Gleason grading system is used to help evaluate the prognosis of men with prostate cancer using samples from a prostate biopsy.Together with other parameters, it is incorporated into a strategy of prostate cancer staging which predicts prognosis and helps guide therapy. i'm depressed, scared and don't know how to take all of this in. Most cancers have a Gleason score (the sum of the two most common grades) between 6 (Gleason scores of 3+3) and 7 (Gleason scores of 3+4 or 4+3). Picture Prostate Cancer Gleason Score 7 Life Expectancy – Cancer News Update in Gleason Score 7 Life Expectancy Article Related to Gleason Score 7 Life Expectancy : Cancer Symptoms – gleason score 7 life expectancy What Are Symptoms and Signs? Both Gleason score 8 and Gleason score 9 patients showed significantly reduced overall and prostate cancer-specific rates when Gleason pattern 5 was present as one of the patterns in their score. The Gleason score has been used widely as a reference when deciding which treatment plans to take. GOLDEN proSTATE... Posts: 4 Joined: Dec 2020 Dec 18 ... Recurrences do not depend on the Gleason rates but on the success of the treatment. Author: Harvard Prostate Knowledge. If the score begins with a 3, it means the cancer is better defined and slower growing than cells labeled as 4. This system splits Gleason score 3 + 4 and 4 + 3, although they both equal a score of 7. Gleason scores are often grouped together, based on similar behaviour: Grade 2-4 as well-differentiated, Grade 5-6 as intermediately-differentiated, Grade 7 as moderately to poorly differentiated (either 3+4=7, where the majority is pattern 3, or 4+3=7 in which pattern 4 … Group 2: Gleason score of 7 (3+4=7) Group 3: Gleason score of 7 (4+3=7) Group 4: Gleason score of 8 (4+4=8) Group 5: Gleason score of 9-10 (4+5=9, 5+4=9, 5+5=10) What are my treatment options? Men with this diagnosis would commonly be advised to follow the Active Surveillance protocol. These groupings are not entirely accurate, since a Gleason score of 7 is made up of two grades: 3 + 4 and 4 + 3. This means that a Gleason score 4+3=7 tumor is more aggressive and faster-growing than a 3+4=7 tumor. Previous studies confirmed the significant difference in biochemical recurrence-free survival following radical prostatectomy between Gleason score 3+4 and 4+3 21). What is a Gleason score? G3's do NOT (<.1%) progress/metastasize into problematic G4's. Gleason grades 1, 2, and 3 represent lower and moderate risk tumors. Gleason 3+3 is a hard six in prostate cancer. Gleason grading 1 is a strong predictor of survival among men with prostate cancer (PCa). Score is obtained by adding grade # of most prevalent cell type to grade # of second most prevalent cell type. Men with more advanced or aggressive cancer are more likely to have a relapse after treatment. Grade group: 3 or 4; Gleason score: 7 (4 + 3) or 8; Treatment. Gleason score: 7 (3 + 4) Stage 2C. We found a significantly higher risk of PC-specific mortality and all-cause mortality among men with GS 3+5 or 5+3 compared to GS 4+4 PC, … Urology 56:823-827, 2000. Jonathan Oppenheimer, MD, was one of the first pathologists to study Gleason 6 tumors. SEE COMMENT. But despite a Gleason score of “7 out of 10” (which sounds advanced), Gleason score 3+4=7 cancers are relatively low-grade and virtually never result in death within even 10 years of diagnosis. Categorization of Gleason score (GS) 8 prostate cancer (PC) into one prognostic group has been proposed. Beginning treatment with ADT plus Chemo is a relatively new concept, so there is no data when patients will become resistant depending on the Gleason score. Charlie5168. Gleason score is the sum of the two most prevalent Gleason grades: primary and secondary, designated according to separate rules for biopsy and prostatectomy ; If only one pattern is present, the primary and secondary patterns are given the same grade (ex: 3+3=6) Systematic needle biopsy sets contain cores from different anatomically designated sites - PROSTATIC ADENOCARCINOMA, GLEASON GRADE 6 (3+3). The Gleason score is the most common system doctors use to grade prostate cancer. Adding these numbers together will yield the overall Gleason sum or score. What treatment is best is never clear. There’s considerable expert opinion that Gleason 3+3 PCa does not behave like cancer and may never become life threatening. The CCP score may help to more accurately select for active surveillance candidates.” Looking at the three diverse studies above, it becomes obvious that conclusive evidence as to whether Gleason 3+3 cancer behaves like cancer is not yet to be had. Which treatment you and your doctor decide upon will depend on both your Gleason test scores and stage of prostate cancer. Gleason score can be misleading to patients. What Do the Different Gleason Scores Mean? Now can a 3-3 progress to a 3-4, yes it can, I forgot who posted last week but his profile was he was a 3-3 in 2002 and is now based on latest biopsy is a 3-4, just imagine he did not have any treatment for 18 years and no side effects from any procedure. Gleason score 3+4=7 tumors still have a good prognosis (outlook), although not as good as a Gleason score 6 tumor. But if they understand that Gleason 3+3=6 is the best (least aggressive) type of cancer tissue, the whole understanding of a man’s cancer changes, and becomes clearer. How can it help you decide on the right treatment for your prostate cancer? This difference may seem trifling, but it represents a significant difference between two grade 7 cancers. Categorization of Gleason score (GS) 8 prostate cancer (PC) into one prognostic group has been proposed. The Gleason Score is based on how aggressive the patient’s prostate cancer is. Using Gleason 4+4=8 as the referent, Fine and Gray competing risks regression analyses modeled the association between Gleason score and prostate cancer-specific mortality (PCSM). Epstein JI, Zelefsky MJ, Sjoberg DD, et al. This gives your doctor an idea of how the cancer might behave and what treatment you need. A Gleason score 4+3=7 tumor is more likely to grow and spread than a 3+4=7 tumor, yet not as likely as a Gleason score 8 tumor. A Gleason score 7, as your father-in-law has, represents either a (3+4) or (4+3) cancer. Of course, such findings could also be viewed from the inverse perspective: the low Gleason score patients do well on almost any treatment for prostate cancer that we administer, from … The Gleason score (GS) is the sum of the primary and secondary patterns with a range of 2 to 10. Gleason number is made up of 2 parts reflecting the the two lobes of the prostate and these are added together. Tumor (T):How large is the primary tumor? Therefore, if we go back to our example, 3 and 4 would be added together for a sum of 7. Still, to the eye of a pathologist, a Gleason 6 looks like a malignancy. These data provide important information for counseling patients with Gleason 7 prostate cancer on the natural history of the disease and may inform treatment decisions. If your most common grade is 3 rather than 4, you are in Grade Group 2. Higher percentage of Gleason pattern 4 in biopsy was significantly associated with not only higher incidence of Gleason score ≥7 but also larger tumor volume and higher pathologic stage (pT3) in prostatectomy specimens. Traditionally, prostate As the article indicated a gleason grade of 4+3 is more aggressive than a score of 3+4. A diagnosis of stage I prostate cancer indicates that the cancer is only within the prostate and hasn't disseminated to the lymph nodes or other parts of … > 75% of all prostate cancers diagnosed are the INSIGNIFICANT Gleason 6 (3+3) > most men with Gleason 6 (3+3) prostate cancers do NOT need treatment (focal or total) > most men diagnosed with the Gleason 6 (3+3) prostate cancer are OVERTREATED. I am of the personal opinion the a 4+3 should be treated, in other words, I would nor recommend active surveillance.
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