Prostate Cancer

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How Gleason Grade Determines Treatment

Dr. James Brooks Stanford Medicine

The Gleason Score determines how aggressive prostate cancer is and also provides information on how to proceed with treatment. To calculate a Gleason grade, the pathologist will study the tumor cells taken from a biopsy and see how the cells are organized.

A Gleason score will let oncologists know when to wait and watch or when to treat, assuming the patient is young enough to benefit from treatment (under age 70). Lower numbers translate into better risk factors, and different doctors may approach treatment differently.

Patients who have high-risk cancer, meaning they have high Gleason scores and a high PSA (over 20), will usually be treated aggressively. Studies show that patients who fall somewhere in the middle are likely to benefit from treatment because it prolongs life expectancy. Still, the decision on what approach to choose will depend on several factors, including the risk-benefit ratio of the treatment options.

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Dr. James Brooks is a urologic oncologist at Stanford Hospital & Clinics and an associate professor in the School of Medicine. Read More