Proposed Prostate Cancer Grading System Simplifies Understanding

By Author: Gregory Echt
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Prostate cancer impacts an estimated 180,000 American men each year. While this disease is considered among the most treatable with 26,000 deaths attributed to it annually, it is still a scary diagnosis for any man to receive. Complicating matters, some doctors say, is a very difficult to understand grading system based on the old prostate specific-antigen test Gleason scores. The current system makes it very difficult for men to understand exactly how serious their particular case might be.

Hoping to make it easier for men to understand their diagnosis and for doctors to explain it, doctors have proposed a new grading system. Also based on the Gleason scores, the new system would rate prostate cancer based on the prognosis and more accurately reflects the biology of the cancer present.

The new grading system is based on a five-point scale. Cancers determined to be the lowest risk – those with the most favorable prognosis – would earn a one score. The most aggressive, poorest prognosis cancers, would rate a five on the scale. The current Gleason system has 25 different grading combinations that are easy to ...
... misunderstand. A Gleason 3 + 4 score, for example has a much better prognosis than a Gleason 4 + 3. Despite the differences in prognosis, both scores are sometimes described as “7” to patients, leading to some confusion.

The proposed replacement system has been used by some doctors for a few years alongside the standard Gleason score grades. Doctors who have used it, so far, have reported the new five-point scale is much easier to explain to patients while enabling them to better understand their prognosis and what treatments might be required. The new grading system has also been embraced by the World Health Organization.

How soon the new grading system will be embraced by clinicians across the United States remains unclear. Some doctors are hopeful it will happen soon. In the meantime, men who are diagnosed with prostate cancer are urged to carefully discuss their prognosis with their healthcare providers. It is also advised that men take the time to discuss all treatment options presented so they can carefully review risks and benefits.

Prostate cancer is a risk for all men as they age. With that in mind, men should talk to their doctors about when routine screening should begin. The exact age may hinge on a man’s personal risk factors for the disease. Routine screening can lead to early detection and potentially lifesaving treatment.

About Author
Dr. Echt and his team at the Prostate Seed Institute offers the most highly sophisticated methods of radiation therapy available in the United States, equal to that found in major medical center and academic settings. These include prostate seed implantation, high dose radiation implants, and external beam radiation with image-guided and intensity-modulated (IGRT and IMRT) capabilities.