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
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.
NCCN Guidelines for Patients
Prostate Cancer, Version 1.2016
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
What does the score mean?
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
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.
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