Simpler Prostate Cancer Grading System Proposed

Tumors fall into 1 of 5 grade groups based on what pathologic findings indicate about prognosis.

Source: Simpler Prostate Cancer Grading System Proposed

I have been counseling men with prostate cancer on their treatment options for many years.  One of the most difficult parts of diagnosing prostate cancer is explaining to the patient and family what his “cancer” means.  I have started with the most important prognostic factors of gleason score and PSA to explain how their prostate cancer is compared to other men.

I’ve explained how the cancer scoring system goes from gleason 2 to 10, but really the least aggressive cancers have a gleason score of 6.  There have been less than a handful of patients that have been diagnosed with a score of 5 in my career.  For the thousands of men that I have counseled, I used to translate their gleason score from 1-4 with a 6 translating to a 1 and a 7 to either a 2 or 3.  Fortunately the urology field is adapting a similar scoring system.

The new grading system simplifies the scoring to a scale of 1-5, with 1 being the least aggressive and 5 the most aggressive.  The old gleason 7 was made of of 2 types, a less aggressive 3+4 and a more aggressive 4+3.  This should help men and their loved ones better understand the type of prostate cancer they have.

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