Gleason range 2-10

Probably because they have no symptoms which would lead to a biopsy including no increase in psa! A majority of older men have indolent PCa but never know it and never need treatment.
Bob

There are men here with both Gleason 8 and 10 cases.

They no longer consider any Gleason <6 to be PC.

David

We do have quite a few 8's. 10's are more unusual, especially on the green side of the sod. The one Gleason 10 I have met personally was only a 10 briefly, as I recall. He was downgraded to a 9 on a second opinion.

What follows is my layman's impression. Not an expert. Parts of it are probably wrong...

As for Gleasons less than 6 they generally aren't reported to the patient because the do not, in themselves, require any action. Gleason "scores" are the sum of the two most prevalent Gleason types (or "grades") seen in a sample of tissue under a microscope. They are descriptions of what the cells look like. Gleason grades 1 and 2 are mildly messed-up looking cells that, despite being peculiar looking, do not exhibit the characteristics of invasiveness and uncontrolled growth that characterize cancers. Gleason type 3 cells are on the borderline. Tissues that have a few of them -- Gleason 5(2+3) -- or even quite a few of them -- Gleason 5(3+2) -- don't ever seem to cause much trouble and generally aren't reported on biopsy reports. (You do see them, I think, on evaluations of tissue removed in a TURP procedure.)

There is some current controversy about what to do in reporting tissues that are uniformly Gleason type 3 cells -- Gleason 6(3+3). Tumors of that sort do often grow excessively and invade other local tissues by growing into them. They do not appear able to travel through the bloodstream and cause distant tumors (metastases) as can tumors involving the more aggressive Gleason grades 4 and 5 cells.

In theory you can have a Gleason 6(4+2). Can't remember one right off hand but I think they happen. That would be a pretty aggressive Gleason 6.

TDubb said...
It also seems 6,7,9 are the primary scores I've seen here. Haven't seen an 8 or 10.

I inquired about the same, especially a G8, on another forum I frequent. It seems that, at least for a G8, that they aren't that uncommon, as several of the guys on there piped in with a Gleason 8 diagnosis.

WOHLL
Dude you need to elect treatment! Gl8 is nothing to delay treatment for!
Bob

Break60 said...
WOHLL
Dude you need to elect treatment! Gl8 is nothing to delay treatment for!
Bob

..Yes I agree..

Newly diagnosed Gleason 8

DadOf12 said...
Yes, we G8's are here.

Been a while since I visited here; but thought I would see how things are going, and couldn't resist the urge to chime in. Maybe someone should start a G8 thread, like the G9's have. ;-)

-Bob

Hey Bob, thanks for commenting. From what I've seen, G8-10 have pretty common risk status in many studies. Studies tend to lump them together as all "high risk", though there seems to be a rather unfortunate increase in aggressiveness with the formation of the type 5 de-differentiated cells. Those rascals are so rogue they're more easily metastatic, which is what so many of us are wary of.

Of course you're welcome to peruse the G9 topics, as I think most of them are quite applicable to G8 situations. Treatments, risks, and so on I believe are quite similar.

do a search,there is a gleason 8 thread.im an 8,4+4 with a bone met on one of my hips.

JNF said...
I remember seeing a chart with incidence of each G grade/score, but I can't find it. My recollection is that more than 50% are G6, about 25% G7 and the rest G8-10. I will keep looking.

Jack, here's one reference I found

"Favorable-risk prostate cancer is characterized as a Gleason 6 or less, a PSA 10 or less, and T1c-T2a disease.5 As a result of stage migration due to PSA screening, the proportion of newly diagnosed patients who fall into the ‘favorable-risk’ category has increased, and now constitutes 50-60% of patients. While patients with these characteristics have a much more favorable natural history and progression rate than those with a higher Gleason grade or PSA, some of them still progress to advanced, incurable prostate cancer and death."

prostate-cancer.org/active-surveillance-for-favorable-risk-prostate-cancer-what-are-the-results-and-how-safe-is-it/

But like you not the chart I remembered, so will keep searching on Gleason score frequency distributions.

LupronJim

here's one by age, though black men have a higher incidence than Caucasian men

msc.sagepub.com/content/16/2/98/T1.expansion.html

Table 1
Frequency of prostate cancers by detection mode (PSA detected or clinical), stage (localized or advanced), Gleason score (GS) categories (<7 or ≥7) and age groups, in men aged 50–69 years with prostate cancer diagnosis between 2002 and 2005

edit- I could not figure out how to format it properly, better to use the link, One section for PSA tested and another section for clinically daignosed, each with 3 subsections.

Since this is pre-2006 data, my guess is with the current OD/OT issue, there are even more G6's and G7's by percentage versus G8-G10 than there were 10 years ago

Age group (years)
50–54 55–59 60–64 65–69
n (%) n (%) n (%) n (%)
PSA tested 12092 13787 10060 7903

PSA-detected cancers* 134 -100 344 -100 487 -100 549 -100

Localized cancers 125 -93 310 -90 428 -88 459 -84
Advanced cancers 9 -7 34 -10 59 -12 90 -16

Gleason Score <7 100 -75 259 -75 354 -73 358 -65
Gleason Score ≥7 34 -25 85 -25 133 -27 191 -35

Localized & GS <7 99 -74 246 -71 342 -70 338 -61
Localized & GS ≥7 26 -19 64 -19 86 -18 121 -22
Advanced & GS <7 1 0 13 -4 12 -2 20 -4
Advanced & GS ≥7 8 -6 21 -6 47 -10 70 -13

Clinically diagnosed cancers†128 -100 352 -100 605 -100 936 -100

Localized cancers 96 -75 279 -79 458 -76 698 -75
Advanced cancers 32 -25 73 -21 147 -24 238 -25

Gleason Score <7 65 -49 172 -49 263 -43 401 -43
Gleason Score ≥7 63 -51 180 -51 342 -57 535 -57

Localized & GS <7 61 -48 162 -46 242 -40 362 -39
Localized & GS ≥7 35 -27 117 -33 216 -36 336 -36
Advanced & GS <7 4 -3 10 -3 21 -3 39 -4
Advanced & GS ≥7 28 -22 63 -18 126 -21 199 -21

*PSA-detected cancers were identified from ProtecT study
†Clinically diagnosed cancers were identified from ECRIC

Post Edited (LupronJim) : 4/3/2014 11:47:05 AM (GMT-6)