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A biopsy confirmed that there was a lesion (Gleason 9 4+5). My Urologist has hopeful that with a treatment plan that included IMRT and ADT plus a second-generation Hormone agent there was still a high likelihood of a cure.
There’s considerable expert opinion that Gleason 3+3 PCa does not behave like cancer and may never become life threatening. However, there’s robust debate as to whether Gleason 3+4 (Grade Group 2) disease can qualify for AS. Since Gleason 4 PCa can be more aggressive, is AS a foolish risk?
In theory, Gleason scores could range from 2 to 10, but pathologists today rarely give a score between 2 and 5 and are more likely to be in the range of 6 to 10 with 6 being the lowest grade of prostate cancer.
With a Gleason Score of 3+4, the cancer is likely to grow and spread at a moderate pace. However, with a primary score of 3 and a secondary score of 4, the outlook is fairly good. Several years may pass before the cancer becomes a problem, and treatment may be needed to prevent issues.
For example, if the Gleason score is written as 3+4=7, it means most of the tumor is grade 3 and less is grade 4, and they are added for a Gleason score of 7. Other ways that this Gleason score might be listed in your report are Gleason 7/10, Gleason 7 (3+4), or combined Gleason grade of 7.
So let’s assume first that he gets diagnosed with low-risk prostate cancer tomorrow (clinical stage T1c, PSA 3.7 ng/ml, Gleason score of 3 + 3 = 6). Here’s what the life expectancy tool tells him:
If the primary pattern, or the most common pattern, is grade 3 and the secondary pattern is grade 4, the Gleason score is 3+4=7. If the tumor is the same grade everywhere, that grade is...