Wednesday, September 24, 2014

Gleason score - A pathologist's experience and explanation




Whilst we generally understand and accept the Gleason score given with our biopsy's. It's impact is quite subjective.

Yes we do not usually have the opportunity to share a discussion with a pathologist.
I thank 1Randy for sharing his discussion with a pathologist in Us TOO Prostrate Cancer support group meeting.

I reproduce 1Randy's post below for your attention

Hi guys. At our cancer support group meeting last week we had a Patholigest from Community Hospitals if California, Dr. Honda. He has done thousands and thousands of reports for over twenty years. He basically only does Prostate and Breast Cancer biopsys. He showed us how he rates the slides and explained the Gleason scoring in detail. Many bits of information I had never heard. Things we don't hear from our Drs. I thought if share some things. These are some bits if info. 
Gleason 10: He said in all the years he had been doing biopsys he has never seen a 10 that hasn't spread to other organs. 
Gleason 9: A 9 he said is slightly better than a 10. Most have spread and have a very high rate of reoccurance. 
Gleason 8: Slightly better than 9. Sometimes it has spread and has a high rate of reoccurance. 
Gleason 7: Thats mine. Better than an 8. Once in a while it can spread outside the capsule and has a good chance of reoccurance. 
Gleason 6: This one was interesting. I told him some people say a six is not serious. He told us a 6 is the most common. It's still cancer if course. It can still spread. Not as serious if a guy had one core if twelve possitive with 5% or 10% involvement. 11/12 cores positive with 75% involvement is a totally different thing. That can break out.
 
Gleason 5 and under depends in many factors.
 
He said we all can't just go by the Gleason score. Family history is a huge factor. Tumor size also. How many samples are positive. Basically it's all serious unless you have very low numbers. As I've said before the Amarican Cancer Society had said Prostate cancer is the second biggest killer of men next to lung cancer. He was speaking only as a Patholigest. These are facts but he said some Drs sugar coat your scores so you don't worry do much. I'm sure prostate cancer isn't our biggest problem in that the biggest worry is if it had spread to other organs. I just wanted to share. Hope no takes offense. This was information we all can look at to help. He makes no determation about treatment, he said that is between a guy and his dr. All he does is look at slides. Good luck to us all! Randy.


Thank you Randy and Dr Honda.  Visit Us TOO prostrate support group here:

http://www.inspire.com/groups/us-too-prostate-cancer/discussion/gleason-scoring/?ref=as&asat=199297090

Take care

Allen Lai



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