Commentary
Video
Understanding Gleason Score During a Prostate Cancer Diagnosis
As part of its Speaking Out video series, CURE talked to Dr. Brian Keith McNeil, on behalf of ZERO-End Prostate Cancer, about understanding Gleason Score and prostate cancer risk.
A Gleason score is a system used to help doctors understand a patient's prostate cancer. According to Dr. Brian Keith McNeil, this score is determined by looking at a sample of the prostate cells under a microscope to see how they are shaped and organized. The score typically ranges from 6 to 10.
As part of its Speaking Out video series, on behalf of ZERO-End Prostate Cancer, CURE spoke with McNeil, vice chair of the Department of Urology at SUNY Downstate Health Sciences University, about understanding one’s Gleason Score and how it relates to prostate cancer risk.
He explains that the score is often given as two numbers that are added together, such as 3+4=7. The first number represents the most common type of cancer cells found in the sample, and the second number represents the next most common type. This two-part score provides a more detailed picture of the cancer's makeup. McNeil notes that the lowest combined score a patient can receive is 6 and the highest score is 10.
The Gleason score is one of several tools used for risk stratification, a process of classifying a cancer as low, intermediate, or high risk. McNeil acknowledges, however, that doctors also consider other factors, such as the patient’s prostate-specific antigen (PSA) blood level and the results of a physical exam.
For patients with low-risk cancer, he explains that active surveillance may be an option. This means the cancer is less likely to spread quickly and can be watched closely with regular check-ups and tests rather than being treated immediately. McNeil adds that this approach helps reduce anxiety by showing that the cancer is being carefully monitored.
On the other hand, high-risk cancers are more likely to spread. For these patients, treatment is typically recommended. McNeil says that options often include surgery or radiation. In some cases, a combination of these treatments may be used. He also notes that hormonal therapy, which works by starving cancer cells of testosterone, is another potential treatment for high-risk patients.
To help navigate a diagnosis, ZERO-End Prostate Cancer has a variety of resources available, such as podcasts, virtual and in-person support groups, and a mentorship program that can provide guidance from diagnosis through treatment and recovery.
