Help With Understanding My Gleason Score

The score is based on the density of the cancer seen (1) most often and (2) second most often in the biopsy slides. The higher the density the higher the score and the higher the risk of progression and the more urgent the need for treatment. The two scores are added to get the total Gleason score. So a score of 6 or lower is lowest risk and a score of 8-10 is considered high risk. A score of 7 is intermediate risk but 3+4 is lower risk than 4+3. Other factors enter into the equation like the number of core samples with cancer and where the cancerous cores were located.
I'm sure your doctor has told you the implications of your findings in terms of what treatment if any is recommended.

Deebo
Welcome to our forum, though sorry to have to meet you here. I'll link below a web page that explains it in some detail. But in brief, here's how it works. The pathologist examines the tissue under a microscope and looks for cells that are less well structured than normal cells. The more a cell appears to be more poorly organized than a normal cell, the higher its Gleason grade. Gleason grades run from 1 to 5, with 1 being nearly normal and 5 being very highly disorganized (see illustration in the linked article). The pathologist then determines the Gleason grade that applies to the greater number of non-normal cells and also the grade of the second most present non-normal cells and adds them to arrive at a Gleason Sum.

So what your doctor has shown you is that your predominant pattern of cancerous cells is Gleason 3 and the pattern of your second most common cancerous cells is Gleason 4 which equals a Gleason Sum of 7. In the world of Prostate Cancer (PCa) your risk of spreading disease or recurrence after treatment is generally greater the higher your Gleason sum.

In your case your 3+4=7 puts you in the intermediate risk group. Because your predominant score is 3 and the secondary cells are 4 means you may have somewhat lower risk than if it were the other way around (4+3).

Here's the link. I also suggest you read the sticky thread at the top of this discussion board for more info to help you understand PCa and treatment options

www.usrf.org/news/070703_finasteride/gleason/gleasongrading.html?o=37891&l=sem&qsrc=990&qo=serpSearchTopBox&ad=semD&ap=google.com&an=google_s&am=broad

Dr. Who - this is a bit OT, but thank you. . . you have just made my day. As you may have read, I'm new here too. I, too, am a 3+4=7 case, and every time I see someone with a lot of experience say that these cases can be "cured" my heart skips a beat and does a "happy dance." I have good days (emotionally) and bad days. Today was a bad one, until I read your comments.

Now I feel better.

To Deebo - Now that you know what the Gleason score is, the next step should be, with G(3+4) to ask that your slides be send to an expert in Prostate pathology, such as Dr Jonathan Epstein, at Johns Hopkins, for a second opinion. The reason is, that most local pathologists look at many different types of slides, and reading is a subjective thing. So you want someone who reads only prostate slides to have a look and render an opinion. A second definitive opinion from an expert will help guide you to the right treatment, or as NKinney says, to whether you NEED treatment at al.

Gentlemen,

I think we may have gotten a bit confused about Deebo. If you read his previous thread on "
Lupron Injection Treatment" you will see that he had RP and ART several years ago and his PSA has recently started to creep up again. He started ADT a few months ago, presumably to keep a lid on a recurrence (PSA was 3.15 when he started ADT and is 0.03 now). Some of the discussion here seems to apply to someone recently diagnosed so maybe some of you didn't notice his previous threads.

Deebo,

Now that you know all this fascinating stuff about yourself you can think about creating a signature (like the information I have under this comment). It saves you from much of the need to repeat yourself to bring new members into your conversations. If you need help setting up a signature just click the envelope icon on the left under my name to send me an email. I'll be glad to coach you.

--PDA