Question on Gleason Scores

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Veteran Member

Date Joined Apr 2008
Total Posts : 1132
   Posted 9/11/2009 6:40 PM (GMT -6)   
My Gleason was an 8 (4+4).   My question is does Gleason start out low and go up in grade.  For example, could I have had a Gleason of 6 and the cancer goes undetected and becomes an 8.   Appreciate any input.  
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 9/11/2009 6:51 PM (GMT -6)   

Your gleason score is made up of two numbers, the first is the majority of cancer cell grade in the sample, the second, is the lesser grade, if different, or in your case, it can be the same.

Yes, as the cancer grows and if it becomes more agressive, it would increase the gleason score. The cancer cells are rated from 1 to 5, 5 being the most agressive, 4's being moderately agressive.

There are still a lot of other variables and factors, of course, we are talking about PC, lol. Nothing is easy. There are men that are gleason 6, and in their lifetime, it never gets higher. And there are other men, who start out low, and over time they become more and more agressive.

Hope this helps. A good book on prostate cancer would explain it much better than I can, but that's the general gist.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out after 38 days

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2461
   Posted 9/11/2009 9:15 PM (GMT -6)   
My understanding from reading Dr Walsh's book is that normal prostate cells have a certain shape and composition, as they mutate to cancer cells their looks and composition changes. The further they are from normal prostate cells the higher their grade. I would assume that the mutation starts slow and getting worse with time. A Gleason 8-10 will indicate that the cells look very different from normal cells.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1

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