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Gleason Grade

If you have had an MRI scan / biopsy and have received a diagnosis of prostate cancer you will now have some results to consider.

You will have been told your Gleason Score which is used to evaluative the stage of your prostate cancer, how aggressive the cancer is and how likely it is to spread outside of the prostate.

Many people with a new diagnosis of prostate cancer will want to know their outlook and to understand the treatment options that are likely to be appropriate for them.

The Gleason Grade helps to determine both of these.


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The Gleason Score and Grade Groups


To find the Grade Group and Gleason Score, a pathologist looks at several samples of cells (biopsies) from your prostate under a microscope.

The Gleason Grade refers to the pattern of cancer cells in the prostate. The pattern structure of these cells indicates how quickly they are likely to grow. The different patterns are graded 1 to 5, with Grade 1 being very similar to typical prostate tissue, and Grade 5 being very different to typical prostate tissue. Grades 3, 4, and 5 are cancer.

Prostate cancers often have areas with different grades. The Gleason Score is derived from adding the most common grade in the samples to the second highest grade. 

The first score is the most common grade in all the samples. The second is the highest grade of what is left. When these two grades are added together, the total is called the Gleason Score.


The prostate cancer Grade Groups and Gleason Scores:

  • Grade Group 0: below 3 + 3 = 6
  • Grade Group 1: 3 + 3 = 6
  • Grade Group 2: 3 + 4 = 7
  • Grade Group 3: 4 + 3 = 7
  • Grade Group 4: 8
  • Grade Group 5: 9 – 10

Grade Group 0: below Gleason Score 3 + 3 = 6

This is a finding of no cancer in the prostate gland.

Grade Group 1: Gleason Score 3 + 3 = 6

This is considered early-stage prostate cancer and may not progress further or may progress slowly. Men with this diagnosis would commonly be advised to follow the Active Surveillance protocol.

For these men HIFU Focal Therapy is a viable alternative treatment.

Grade Group 2: Gleason Score 3 + 4 = 7

This is considered early-stage intermediate prostate cancer and is unlikely to cause harm in the short term. Men may be offered Active Surveillance or more radical treatments such as Radical Prostatectomy or Hormone / Radiotherapy treatment. Men under the age of 70 who are in good health are likely to be encouraged to have a Radical Prostatectomy.

Men with a Grade Group 2 prostate cancer are highly likely to be suitable for HIFU Focal Therapy and ought to consider this treatment option.

Grade Group 3: Gleason Score 4 + 3 = 7

This is considered intermediate-stage prostate cancer and needs treatment to ensure that it does not spread further. Men will be offered either Radical Prostatectomy or Hormone / Radiotherapy treatments.

Many men with a Grade Group 3 prostate cancer circumstances may be viable for HIFU Focal Therapy, depending on a detailed review of their clinical files, and ought to consider this treatment option.

Grade Groups 4 and 5: Gleason Score 4 + 4 = 8 and above

These are considered advanced-stage prostate cancer and men with these prostate cancers benefit substantially from radical treatments such as Radical Prostatectomy or Hormone / Radiotherapy treatment.

HIFU Focal Therapy would not be suitable in these cases.


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Get In Touch

As a group of consultants we are passionate about prostate cancer sufferers knowing about all of their treatment options.

We know that settling on the right treatment is a big decision for you. If you would like to speak to one of our friendly and knowledgeable patient advocates about your diagnosis and the HIFU Focal Therapy treatment option then please do not hesitate to get in touch today.

All enquiries to The Focal Therapy Clinic are confidential, and we are delighted to offer our advice and support with no obligation.