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Gleason Score

Posts: 4
Joined: Apr 2011

I would like to know what is the Gleason score for the following
biopsy results:
Tumor found in 1 out of 12 prostatic tissues.
The Tumor score is 4 (gleason). This tumor replaces about 10 percent of
the tissue and less than 5 percent of the total tissues.
No other Tumors were found.

Two things strange:
First, There is only one number, not two.
Second, The tumor found was less than 50 percent, so it doesn't meet
the Gleason criteria.

So, The Gleason score is 4*2=8, or a second biopsy is needed?

Posts: 34
Joined: Apr 2011


I was told by 3 urologists (my own through Kaiser and two independents) that any Gleason at 5 or under is low risk and "almost undetectable". Of the 3 urologists, a Gleason 5 or under is rarely seen. Gleason 6 is mid aggressive and the most common and treatable. You might ask for a second opinion on the reading of your slides or if you have confidence in your medical people, active surveillance with regular PSA tests should be sufficient.

hopeful and opt...
Posts: 1832
Joined: Apr 2009

get a written copy of your results.....less than 50 percent is the involvement of the cancer in the core...(less involvement the better)...always a good idea to get a second opinion of the slides by another pathologist, at say bostwick or johns hopkins, since analyzing gleasons is complicated and you do not want to be under or over treated.

VascodaGama's picture
Posts: 2305
Joined: Nov 2010


I think that it would be better for you and for others following your case that you place questions/report in your first thread “Duration between biopsy and surgery”. It will give you the chance to get better answers.

Regarding “Gleason Score”, this is the way doctors use to classify the aggressiveness of the prostate cancer. The “Gleason Patterns” indicate the status of the cancer cells which scale goes from pattern 1 to 5. Pattern 1 and 2 are named “well differentiated”; Pattern 3 is “moderately-differentiated”; and Patterns 4 and 5 are poorly differentiated”.

When pathologist analyses in the microscope the samples (biopsy cores) taken from your prostate, they will compare the cells’ shape and other characteristics with the Gleason Pattern Scale and attribute a classification to your cancer (4 in your case). To access aggressiveness they will add two of the patterns (the first most prevalent and the second) to indicate a score, which in your case it is (4+4) = 8.

Gleason score goes from 2 (1+1) to 10 (5+5); being the score of 2 to 4 classified as “insignificant risk”, score 5 to 6 as Low Risk, score 7 as Intermediate Risk and score 8 to 10 as High Risk.

Your results of only one number of 4 means that the pathologist found only pattern 4, therefore the Gleason score becomes 4+4=8.
Have a look at this site;

Hope that my insight is of help.


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