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Used with permission from Jonathan I. Epstein, M.D.

Glands are small, well-formed, and close

together. There are only small signs of cancer.

Glands are larger and have more space in

between them.

Glands are even further apart, are darker, and

have different shapes.

There are hardly any glands. Cancer cells have

lost their ability to form glands. Clumps of cancer

cells are invading other tissue.

Often, there are no glands. There are sheets of

cancer cells throughout the tissue.

17

NCCN Guidelines for Patients

®

Prostate Cancer, Version 1.2016

2

Cancer staging

Gleason score

Figure 5.

Gleason grades

To obtain a Gleason score, doctors first assign the cancer two Gleason grades. The grades are

combined to obtain a Gleason score. Gleason grades range from 1 to 5.

Chart 1. Gleason score summary

Gleason score

What does the score mean?

2–6

The cancer is likely to grow and spread very slowly. If the cancer is small, many

years may pass before it becomes a problem. Thus, you may never need cancer

treatment.

7

The cancer is likely to grow and spread at a modest pace. If the cancer is small,

several years may pass before it becomes a problem. To prevent problems,

treatment is needed.

8–10

The cancer is likely to grow and spread fast. If the cancer is small, a few years may

pass before the cancer becomes a problem. To prevent problems, treatment is

needed now.