Jump to content

Gleason score may be redefined

Recommended Posts

Jim Marshall (not a doctor) said ...

Gleason score has a few problems:

Gleason score of 6 is usually the lowest score reported.

Prostate cancer with a Gleason score of 6 very often needs no immediate treatment, but 6 sounds like a big number to a patient.

Gleason score of 7 varies depending how it is made up. 3+4 is less aggressive than 4+3.

Gleason scores of 9 and 10 have similar outcomes.


Urologists (including Dr Nick Brook) are proposing to the International Society of Urological Pathology (ISUP, which set the Gleason score as standard) in November that the Gleason score be changed to an ISUP score.


The proposal is that:

  • Gleason score of 6 or less becomes ISUP 1
  • Gleason score of 3+4 becomes ISUP 2
  • Gleason score of 4+3 becomes ISUP 3
  • Gleason score of 8 becomes ISUP 4
  • Gleason score of 9 or 10 becomes ISUP 5


This seems to address all the issues, except for Gleason score of 8: some doctors say Gleason score of 5+3 is just as aggressive as Gleason score 9 and 10.


The big problem will be that if it is changed, at the time of changeover doctors will need to explain the two systems, or they might get a lot of "You said I was a 1, but there’s no such thing on the internet. Can I get another referral?"

... end Jim

Link to comment
Share on other sites


This topic is now archived and is closed to further replies.

  • Create New...