The Grade Group determines the extent to which cancer cells look like normal cells and is the most common system that doctors use to grade prostate cancer. Also known as the Gleason Score, prostate cancer grade groups can identify how the cancer might behave, which allows your doctor to recommend the treatment you need.
How the Gleason Score & Grades Are Determined
Each sample of prostate cancer cells is graded based on how aggressive they look and how quickly they are likely to grow. The Gleason Score is calculated by adding together the two most common Gleason grades.
There are five Gleason Grade Groups, with 1 representing the least aggressive cancer and 5 representing the most aggressive. The Gleason Grade provides a simplified grouping across five categories, including a low grade representing idle prostate cancer. On both scales, higher scores imply a higher chance that cancer will spread quickly.
- Gleason 3+3 = 6 – Grade 1 – Low/Very Low Risk
Only individual discrete well-formed prostate cells. Cancer cells look similar to normal cells and will likely grow slowly or not at all.
- Gleason 3+4 = 7 – Grade 2 – Intermediate Risk
Represents predominantly well-formed prostate cells with a lesser component of poorly-formed cells or groups of cells. The cancer is likely to grow and spread at a moderate pace. However, with a primary grade of 3 and a secondary grade of 4, the outlook is fairly good. Several years may pass before the cancer becomes a problem, and treatment may be needed to prevent issues.
- Gleason 4+3 = 7 – Grade 3 – Intermediate Risk
Predominantly poorly-formed cells or groups of cells with a lesser component of well-formed glands. The cancer is likely to grow and spread at a faster pace than a Grade 2 grade. Treatment may be needed to prevent issues.
- Gleason 4+4, 3+5, 5+3 = 8 – Grade 4 – High Risk
Only poorly-formed cells or groups of cells, some well-formed groups of cells with a lesser component lacking, or normal prostate tissue structure. With a Gleason Grade of 4, the cancer is aggressive and likely to grow and spread more rapidly.
- Gleason 4+5, 5+4, 5+5 = 9/10 – Grade 5 – Very High Risk
Lacks normal prostate tissue structure with or without regions with poorly-formed cells or groups of cells. The cells look very abnormal; the cancer is aggressive and is likely to grow and spread rapidly.
After Receiving Your Gleason Score
Calculating your Gleason Score is an important step in your journey, but you might be wondering… what’s next? Doctors use the Gleason Score to recommend the best treatment plan for you, along with the following factors:
- PSA blood test level
- Stage of your cancer
- How much cancer there is
- Your age and general health
- Genetic factors that can determine where you have an increased risk of developing aggressive cancer
- Your comfort level with treatments and their side effects
With low-grade scores, doctors may also advise that no treatment is necessary and recommend active surveillance (also known as watchful waiting). In any case, it’s important to educate yourself on prostate cancer, treatments, and tests so you can advocate for your health and make informed decisions.
Blog posts from Profound Medical are for general information only. The content should not be considered medical advice. If you are in need of professional medical advice or assistance, please reach out to your local doctor or clinic.
Jun 8, 2023 | TULSA Procedure