Explaining Gleason Score 3+4=7 to a Patient with Prostate Cancer
A Gleason score of 3+4=7 indicates moderately aggressive prostate cancer where most cancer cells are pattern 3 (less aggressive) with some pattern 4 (more aggressive) cells present. 1
Understanding the Gleason Scoring System
- The Gleason score is determined by a pathologist who examines tissue samples from your prostate biopsy under a microscope 2
- The score consists of two numbers added together, representing the two most common cancer patterns seen in your biopsy samples 1
- Each pattern is graded from 1 to 5, with higher numbers indicating more aggressive cancer cells 1
- The first number (3) represents the most common pattern in your biopsy, while the second number (4) represents the second most common pattern 2
What Gleason Score 3+4=7 Means
- Your score places you in the "intermediate risk" category for prostate cancer 2
- The predominant pattern 3 cells (which make up most of your cancer) look relatively similar to normal prostate cells and tend to grow more slowly 1
- The secondary pattern 4 cells are more abnormal looking and potentially more aggressive 1
- This score is more favorable than a Gleason 4+3=7, where the more aggressive pattern 4 cells would be predominant 3, 4
Clinical Significance of Your Score
- With a Gleason score of 3+4=7, the 5-year biochemical recurrence-free survival rate is approximately 82.7% following radical prostatectomy 3
- Your score is one of several factors (along with PSA level and clinical stage) that helps determine your overall risk category and treatment options 2
- Patients with Gleason 3+4=7 have significantly better outcomes than those with Gleason 4+3=7, despite both being classified as Gleason 7 3, 5
Modern Grading Perspective
- In newer grading systems, your cancer would be classified as "Grade Group 2" (out of 5 grade groups), providing a clearer indication that your cancer is in the lower-intermediate range of aggressiveness 4, 5
- This newer system helps patients better understand their cancer's aggressiveness, as the traditional Gleason system can be confusing 6
Common Misunderstandings to Avoid
- Many patients misinterpret Gleason scores as being on a scale of 1-10, but the practical range is actually 6-10, with 6 being the least aggressive cancer that can be diagnosed 4, 7
- Your score of 7 doesn't mean your cancer is "average" in aggressiveness - it indicates intermediate risk that requires appropriate attention 1
- Not all Gleason 7 cancers are the same - your 3+4 score has a better prognosis than a 4+3 score 3, 5
Next Steps
- Based on your Gleason score and other factors like PSA level and clinical stage, we'll discuss appropriate treatment options 2
- Treatment decisions will consider not only your cancer characteristics but also your overall health status and life expectancy 2
- Regular follow-up will be important, as the median time between PSA increase and appearance of metastases is approximately 8 years 2