What is the Gleason score? Explained simply

TL;DR

• The Gleason score describes how prostate cancer cells look under a microscope.
• It helps doctors understand how aggressive the cancer appears.
• Scores range from 6 to 10, with higher scores meaning faster-growing cancer cells.
• The score is based on two patterns added together.
• It supports discussions about next steps but does not predict outcomes on its own.

What is the Gleason score in simple terms?

The Gleason score is a grading system used in prostate cancer to describe how abnormal cancer cells look compared to healthy prostate tissue.

In simple terms:

It tells how organized or disorganized the cancer cells appear.

More disorganized cells usually grow and spread faster.

The Gleason score is determined after a prostate biopsy, when a pathologist examines tissue samples under a microscope.

How is the Gleason score calculated?

The Gleason score is calculated by adding two numbers:

1. Primary pattern – the most common cell pattern seen
2. Secondary pattern – the second most common pattern

Each pattern is graded from 3 to 5:

• 3 = cells look closer to normal
• 5 = cells look very abnormal

Example:

• Primary pattern: 3
• Secondary pattern: 4
• Gleason score: 3 + 4 = 7

What do Gleason score numbers mean?

Here is a simplified breakdown:

Gleason score 6 (3+3)

• Cancer cells look fairly similar to normal cells
• Usually described as low grade
• Often slow growing

Gleason score 7 (3+4 or 4+3)

• Moderate differences in cell structure
• Considered intermediate grade
• The order matters: 4+3 is more aggressive than 3+4

Gleason score 8–10

• Cells look very abnormal
• High grade cancer
• More likely to grow and spread faster

What is Grade Group, and how is it related?

Doctors often also use Grade Groups, which simplify Gleason scores. They range from 1 (least aggressive) to 5 (most aggressive) and are easier to understand at a glance.

• Grade Group 1 → Gleason Score 6 (3+3)
• Grade Group 2 → Gleason Score 7 (3+4)
• Grade Group 3 → Gleason Score 7 (4+3)
• Grade Group 4 → Gleason Score 8
• Grade Group 5 → Gleason Score 9–10

Why is the Gleason score important?

The Gleason score helps healthcare professionals:

• Describe how aggressive the cancer appears
• Compare prostate cancer types consistently
• Support shared decision-making conversations

It is one part of a bigger picture that may also include:

• PSA test levels
• Imaging results
• Symptoms
• Overall health and age

Does a Gleason score predict prognosis?

No — not by itself.

The Gleason score does not:

• Predict exactly how long someone will live
• Decide treatment on its own
• Replace medical advice

It is a descriptive tool, not a forecast.

Common questions people ask about the Gleason score

Is Gleason 6 really cancer?

Yes. Gleason 6 cells are cancer cells, but they usually behave in a less aggressive way.

Can a Gleason score change?

Yes. Scores can change if:

• More tissue is sampled later
• Cancer characteristics evolve over time

Is a higher Gleason score always worse?

A higher score suggests more aggressive cell behavior, but individual situations vary.

How mama health can support you

Understanding pathology terms like the Gleason score can feel overwhelming. mama health supports people by:

• Offering clear, evidence-based explanations
• Helping you reflect on test results before appointments
• Supporting preparation of questions for your doctor

‍

Disclaimer:

This content is informational and not a medical device.

mama health offers information and support and does not replace a doctor.

‍