If you’ve recently been diagnosed with prostate cancer, you may have received a pathology report that includes something called a Gleason score. For many men, seeing this number can feel confusing or overwhelming at first.
One of the most common questions we hear at Urology Associates is:
“What does my Gleason score actually mean?”
The good news is that the Gleason score is simply a tool that helps your physician understand how prostate cancer may behave and which treatment options may be most appropriate for your individual situation.
In the video below, Kristie Kokeny, PA-C, explains how Gleason scores are determined and why they play such an important role in prostate cancer treatment planning.
What Is a Gleason Score?
A Gleason score is a grading system used after a prostate biopsy to evaluate prostate cancer cells.
During a prostate biopsy, small tissue samples are removed from the prostate and examined under a microscope by a pathologist. The pathologist compares the cancer cells to normal prostate tissue and determines how abnormal the cells appear.
In general, the more abnormal the cells look, the more likely the cancer may grow or spread.
The Gleason score helps your urologist determine:
- Whether the cancer is low, intermediate, or high risk
- How aggressive the cancer may be
- Whether active surveillance may be appropriate
- Which treatment options should be considered
- How the cancer fits into the overall staging process
How Is the Gleason Score Calculated?
Most prostate cancers contain more than one pattern of cells. The pathologist identifies the two most common patterns, grades each from 1 to 5, and adds them together.
Common examples include:
- 3 + 3 = Gleason 6
- 3 + 4 = Gleason 7
- 4 + 3 = Gleason 7
- 4 + 4 = Gleason 8
One important detail is that the first number carries significant weight because it represents the dominant cancer pattern seen in the biopsy sample.
For example, while both 3+4 and 4+3 equal 7, a Gleason 4+3 cancer is generally considered more aggressive because a larger percentage of the cancer contains higher-grade cells.
What Do Gleason Scores Mean?
Gleason 6 (Low Risk)
Often slow-growing and may be managed with active surveillance instead of immediate treatment.
Gleason 7 (Intermediate Risk)
Can be either favorable (3+4) or less favorable (4+3). Treatment options may include surgery, radiation, hormone therapy, or surveillance depending on individual factors.
Gleason 8–10 (High Risk)
More aggressive cancers that are more likely to grow or spread and often require more comprehensive treatment.
The Gleason Score Is Only One Part of the Picture
Treatment decisions are based on more than just the Gleason score. At Urology Associates, we also consider:
- PSA level
- Prostate cancer stage
- MRI and biopsy results
- PSMA PET scan findings
- Age and overall health
- Patient goals and preferences
This comprehensive approach helps ensure each patient receives individualized care.
Understanding the Role of PSMA PET Scans
As Kristie Kokeny discusses in the video above, many patients undergo a PSMA PET scan following a prostate cancer diagnosis.
A PSMA PET scan is an advanced imaging study that helps determine whether prostate cancer has spread beyond the prostate gland. The information from this scan, combined with biopsy results and PSA levels, helps your physician better understand the extent of disease and recommend the most appropriate treatment plan.
After all results are reviewed, you will meet with your physician to discuss findings and next steps.
Expert Prostate Cancer Care in Denver, Colorado
A prostate cancer diagnosis can feel overwhelming, but understanding your Gleason score is an important step toward making informed decisions about your care.
At Urology Associates, we provide comprehensive prostate cancer diagnosis, staging, advanced imaging, and treatment planning for patients throughout Denver and surrounding Colorado communities. Our focus is on clear communication, personalized care, and helping patients understand every step of their diagnosis and treatment options.
If you have questions about your Gleason score or prostate cancer treatment, our team is here to help guide you forward with clarity and confidence.
