Written by Dr.Albana Greca Sejdini, Md, MMedSc
When talking about Gleason Grading System, keep in mind that it is a pathological grading system of the prostate related tumors in their different stages. This Grading scores start from 1 with a maximum rage of 5.
So, score 1 is given to a tumor, which is well differentiated (not progressed beyond its boundary) and score 5is marked with undifferentiated tumor (progressed beyond its boundary and overlapped with other cell layers).
Then the score sums up its total and that stands between 2 to 10. It is done for each tumor detected. The main aim is to see the abnormal development of the cells and the damage occurred due to aggressive behavior of the cancerous cells and lastly, the treatment selection, depending upon the different manifestations.
Let us see little more about abnormal cell development in prostate cancer. Initially, there is a development of neoplasm. The cell is abnormal, not cancerous but may turn into cancer. Now if, it turns into cancer it mainly involves the superficial cells (Comparatively low risk zone). If, the connective tissue cells show development of cancerous growth, it is more dangerous. In his case, the chances of metastases or spreading out to the other parts of the body are more likely.
The health experts have chalked out some ranges, keeping in mind the risk stratification of prostate cancer. The important criteria are Tumor staging, Gleason score and prostate specific antigen. It is better to consider the risk in relation to the said three criteria.
The low risk zone comprises of Tumor staging, Gleason score and prostate specific antigen should maintain T1 -2, Gleason score 2-6, and PSA should be less than 10mg/ml of blood. If you fall in this group the life expectancy is either 10 or beyond after case detection.
The second group is the intermediate group and it comprises of T2b to Tc, Gleason score should be within 7 and PSA level should be 10-20 mg / ml of blood respectively. Here the life expectancy is round about 10 years or less after case detection.
The last one is the high risk zone and it comprises of T3a, Gleason score should be 8-10 and PSA level is 20mg/ ml of blood or more. Here the life expectancy carries a gloomy outcome.I want you to keep in mind also that life expectancy should not be considered in isolation. You should always consider the associated complications of other body systems to get a more accurate picture.
If you belong to low risk zone and due to age the normal life expectancy is less than 10 years, watchful waiting is the best treatment. If, your normal life expectancy is more, either radical prostatectomy orradiation therapy will be the option.
If your case falls in intermediate group, the same regimen of low risk zone treatment is generally followed depending upon the age related normal life span.
In high risk zone, total Androgen deprivation (Sometime with castration) only or in combination with radical prostatectomy is the treatment of choice.
In cases of Metastases (MI), Androgen deprivation and radio therapy is indicated.