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Gleason score for prostate cancer

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In the 1960s, VA researcher Donald Gleason and his colleagues at the Minneapolis VA Hospital developed a grading system to classify the stage and prognosis of prostate cancer. Today, the Gleason score is almost universally used to rate prostate cancer. It is considered the most reliable measure of prostate cancer's chances of growing and spreading.

To find a Gleason score, doctors take a biopsy of a patient's prostate and look at the cells under a microscope. The pattern of cancer cells are ranked from 1 to 5. A score of 1 means cells resemble a normal prostate, with areas of cancer cells small and closely packed. Higher scores mean that the cancer cells are more widespread. Doctors add the score for the most common cell pattern with the next pattern with the highest score.

Total scores range from 2 to 10, with a higher score meaning more advanced cancer and a worse prognosis. Cancers with scores of 2-4 are usually considered benign or slow-growing. Scores of 5-7 are the most common, and are highly treatable. Scores of 8-10 show an advanced stage of cancer ad are unlikely to be cured.

"Every prostate cancer patient knows his Gleason score." –Dr. Bruce Roth, Vanderbilt University

Gleason served in the U.S. Army Medical Corps before going to work at the Minneapolis VA Hospital. He became the head pathologist in 1986. He died in 2008.

Principal investigator: Donald Gleason, M.D.; Minneapolis VA Hospital

Selected publications:

Gleason DF. Classification of prostatic carcinoma. Cancer Chemother Rep. 1966 Mar;50:125-128.

Gleason DF, Mellinger GT; Veterans Administration Cooperative Urological Research Group. Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. 1974. J Urol. 2002 Feb;167(2 Pt 2):953-8.

Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL; ISUP Grading Committee. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason grading of prostatic carcinoma. AM J Surg Pathol. 2005 Sep;29(9):1228-42.


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