The Art of Strengths Coaching

Prostate Awareness 8: Good News Amidst The Gleason Scores

Good news today. Met again with Mark Emberton, who was in fine form. He is excellent to talk with. A pioneer in the field of HIFU, he is professional and very human. Great trusted advisor.

Professor Mark Emberton

The good news to be seen with the following context. Men diagnosed with prostate cancer are given what is called a Gleason Score. Here is a short introduction that can be found at the following site.

Gleason Grade or Score

With prostate cancer, your outlook also depends on how the cells look under a microscope. This is called the grade of your cancer. In prostate cancer, this is recorded as your Gleason score.

A Gleason score of between 2 and 6 is a low grade prostate cancer. It is likely to grow very slowly.

A Gleason score of 7 is an intermediate grade that will grow at a moderate rate.

A Gleason score of 8 to 10 is a high grade cancer that is likely to grow more quickly.

 If your Gleason score is low and you are older or have early stage disease your doctor is likely to suggest watching and waiting (also called active monitoring).

This is because your cancer may not spread or cause any trouble. If you have a high Gleason score, are younger or have higher stage disease your doctor is more likely to suggest you have active treatment such as surgery or radiotherapy.

Gleason Score is made up of Two Numbers

My original biopsy showed a Gleason Score of 7. But such a score is made up of two numbers. Here is an overview from (Yes, I know, but well written.)

Here’s a tricky little feature of the Gleason score for you to keep in mind: The Gleason score usually is reported with the primary cancer number given first, and the secondary cancer number reported second.

For example, if Jack Sprat’s Gleason score is reported as a 4 + 3 = 7, the primary cancer number is a 4, and the secondary cancer number is a 3. Add them up, and they equal a total Gleason score of 7. But remember, not all Gleason scores are equal.

It may sound strange, but if the pathologist classifies Clark Kent with Gleason scale numbers of 3 and 4, which gives him a Gleason total score of 7, Clark is actually in a little better shape, cancerwise, than Jack.

Here’s why: When the primary grade (the first number) is 3, it means that the cancer has not advanced as far with cellular deterioration as cancer with a primary grade of 4 (such as is the case with Jack’s score).

Even though their total scores still equal 7, Jack and Clark’s Gleason scores aren’t exactly the same.

Gleason Score of 7 can be 4:3 or 3:4

As mentioned earlier, my original MRI indicated a Gleason Score of 7, made up of 4:3. On further examination, however, it appears to be made up of 3:4. This is much better in risk terms than 4:3.

(The joy of Gleason Scores. If you Google them, you will come across masses of stuff.)

Mark also showed me the MRI pictures of the cancerous cells. Seems confined to a relatively small area. And he believes quite treatable with HIFU. Combined with the new Gleason Score, this is good news. All the reports and pictures given to me to take home and study if I wish.

The Next Steps

The next step is to do a more detailed MRI. Why? First, accuracy vital when using the HIFU, we need a more detailed picture. Second, the biopsy created collateral damage that tends to cloud the pictures. Need a bit more time for healing and then take new images.

Will do the next MRI at the end of August and meet the Professor again in early September. We will then make a definite decision on the way forward.

Looks promising. Onwards we go.


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