Grading Prostate Cancer with the Gleason System

A diagnosis of prostate cancer is the beginning of the process of fighting the disease. Not every prostate cancer is the same and, in order for treatment to be appropriate and ultimately as successful as possible, it’s essential to determine the specifics of the cancer. As a part of this process, it’s important to grade the cancer.

When prostate cancer is diagnosed, each tissue sample taken during a biopsy is assigned a grade by the pathologist. This specialized doctor examines each piece of tissue under a microscope and determines its grade based on the advancement of cancer cells in this particular area.

Grading is most often done by the Gleason system, a standardized system through which tissue samples are taken from the two largest areas of cancer. These two tissue samples are graded from 1 to 5. A grade of 1 is assigned to the least aggressive cancers, while a grade of 5 is assigned to the most aggressive cancers.

These two grades are added together to determine the Gleason score. A combined score of 2 to 4 is a low grade cancer which tends to be slow growing. In fact, low grade cancers may be slow growing enough that the patient experiences no threat throughout his life.

A combined score of 5 to 7 is considered an intermediate grade. And a combined score of 8 to 10 is considered high grade; high grade tumors are faster growing and quicker to spread to other parts of the body.

In addition to grading, the stage of the prostate cancer must also be identified. This determines how far the cancer has spread - stages one and two are the earliest stages of cancer where it is localized and has not spread, stage three cancer has spread beyond the prostate to nearby tissues, and stage four means that the cancer has spread to lymph nodes and other tissues and organs.

Grading and staging cancer is essential to determining the best possible course of treatment and allows doctors to appropriately set a plan for each patient according to their particular needs and state of health.

About Author

Dr. Echt and his team at the Prostate Seed Institute offer the most highly sophisticated methods of radiation therapy available in the United States, equal to that found in major medical center and academic settings. These include prostate seed implantation, high dose radiation implants, and external beam radiation with image-guided and intensity-modulated (IGRT and IMRT) capabilities.

The Prostate Seed Institute is a non-surgical prostate cancer care center. The founder of the Prostate Seed Institute, Dr. Gregory Echt, is a radiation oncologist who specializes in using radiation to treat cancer.