Why Does My Husband's Gleason Score Have An Extra Number (3+4+5)?

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mariateresa
Regular Member


Date Joined Jun 2007
Total Posts : 95
   Posted 8/7/2007 8:29 PM (GMT -7)   
Hi Everyone,

It's Maria Teresa. I am so very grateful for all of you. Because of this forum, I'm able to "breathe" a little better! Thank you all for "holding my hand"!

Could you help me understand why my husband's Gleason Score has an extra number (3+4+5)?

Thank you!!!

Maria Teresa




This was the results of his biopsy: Five of the eight samples came back positive.

A. Infiltrating, poorly differentiated adenocarcinoma, Glesason Score 8 (3+4+5). The tumor involves approx 70% of the submitted tissue. No perineural or capsular invasion is identified.

B. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 50-55% of the submitted tissue. Perineural invasion identified. Capsular invasion is not seen.

C. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 70% of the submitted tissue. No perineural or capsular invasion is identified.

D. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 60% of the submitted tissue. No perineural or capsular invasion is identified.

E. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 20% of the submitted tissue. No perineural or capsular invasion is identified.

AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 8/8/2007 7:24 AM (GMT -7)   
Hi Maria Teresa,

I'm reading it as if they found some cells with a gleason of 5. It's very confusing from the way it's written. My suggestion would be to send the slides to another facility for a second opinion.

Best of luck to you.

A.

David123
New Member


Date Joined Aug 2007
Total Posts : 9
   Posted 8/8/2007 7:26 PM (GMT -7)   
I have talked with dozens of men and none of them had a third score. It doesn't sound right.

hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 8/8/2007 9:25 PM (GMT -7)   
The way the Gleason score works, the first number is what the majority of the cells are, and the second, what the second type of cells are.  That's why a Gleason of 3 + 4, is better than a 4 + 3, even though both add up to 7.  I haven't heard of a third score, but if it exists, someone in this forum will reply.  (I was wondering why you listed three scores!!)
PSA 4.7 (up from 3.2 one year ago)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology
     Stage T3a, Gleason 3+4, positive margins and
     capsular penetration RIGHT Side
Post Surgery PSA:  March 5:  0.01
5 month PSA, June 13, 2007:  0.08
Adjuvant therapy began June 26 with Zoladex injection
     Radiation to commence in late August
 


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 424
   Posted 8/8/2007 10:27 PM (GMT -7)   
Maria,
 
Found an article that talked about tertiary Gleason scores...
 
Excerpt from article:
 
"The standard prostate pathology report includes a primary and secondary Gleason grade. On some occasions, a tertiary grade is reported. In 2005 an International Consensus Conference of uro-pathologists suggested that the Gleason system for prostatic biopsy reports should be modified to account for the presence of a poorly differentiated or undifferentiated tertiary component. The modified approach would sum the most prevalent primary grade and the highest grade. Thus, in the situation with a primary grade 3 and a secondary grade 4, cancers with a tertiary grade of 5 would be classified as high grade (3+5). This proposal has not been implemented, as the existing system is well rooted in clinical practice"
 
 
Hope this helps...
 
God Bless!
 
Ray
Age 59 y/o - Last 3-4 years of annual general health checkups - PSA 5-6
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 Diagnosed as T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx,   approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks post-op incontinance... Overnite, went from 4-6 soaked pads a dayfrom prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
7/30/2007 ED has improved to point of 60% erection, penetration, climax w/o "toys", but on 50mg "Viagra" (I use $2 Caverta)
 


ldoun
New Member


Date Joined Jun 2007
Total Posts : 19
   Posted 8/9/2007 5:14 AM (GMT -7)   
My pathology reports all had the two score primary and secondary numbers. They also made a point of noting with a statement if ANY grade 5 cells were seen. The three score system seems to me to be a way of noting the presence of grade 5 cells. They also used that in the computed total.
Age 64
5'8" 145#
PSA pre-op 5.2 (12% free)
Gleason 3+4=7
Robotic RP 4/24/07 Dr. Albala, Duke
Post-op- Organ confined Gleason 7
6/18/07 PSA <0.1
10 wk: 0-1 mini pad per day
ED Cialis and VED prescribed


mariateresa
Regular Member


Date Joined Jun 2007
Total Posts : 95
   Posted 8/9/2007 3:57 PM (GMT -7)   
Thank you so much for helping me understand the Gleason rating system better. Ray, thanks for the link! I was searching all over the internet and could not find any information.

I did happen to find in the book, "Report to the Nation on Prostate Cancer" published by the Prostate Cancer Foundation the following information: "In some cases, the pathologist might identify a third pattern, which is less common but that has a higher grade than either of the first two patterns that comprised the Gleason score. The presence of this third pattern might indicate that the tumor is more aggressive than the Gleason score would otherwise imply. For example, if a Gleason 4+3 tumor also has some grade 5 cells, the cancer would be considered as being of higher grade disease overall."

But the link to the information that Ray provided above is a much better explanation and was the answer I was searching for. Thanks again Ray!
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