Understanding The Gleason Score | Prostate Cancer Staging Guide

[@michaelh2716]

I'm 69 y/o with a Gleason Score of 8. My PSA is 4.08 and had been steadily increasing from 2.22 since May 2021. I had a PET CT Scan that showed no METS! The Prostate Ca is localized in the Prostate! (Yeah!) I'll speak to a Radiation Oncologists & a Surgeon within a week (Aug 2023) and then decide which Tx to accept. Leaning toward Radiation, but want to hear from each Doctor first. Your videos have been VERY Helpful!

[@haroldburris3781]

Which did you choose for treatment?

[@michaelh2716]

@@haroldburris3781 Androgen Deprivation Therapy started & Radiation to start in December; 5 days/wk for 8-9 wks.

[@graemeroberts2935]

Excellent explanation, Dr. Scholz. Thank you!

[@dougirvine8615]

Finally someone who can explain the Gleason scale that actually makes sense.....I love my Doctor but he spent twice as much time explaining it and left me confused...THANKS

[@kenzonikolai1469]

you all prolly dont give a shit but does someone know a tool to log back into an Instagram account?? I was stupid forgot my account password. I love any help you can offer me

[@ariryder5473]

@Kenzo Nikolai instablaster :)

[@kenzonikolai1469]

@Ari Ryder I really appreciate your reply. I got to the site through google and I'm trying it out now. Takes quite some time so I will get back to you later when my account password hopefully is recovered.

[@kenzonikolai1469]

@Ari Ryder it worked and I now got access to my account again. I am so happy! Thanks so much you saved my account !

[@ariryder5473]

@Kenzo Nikolai Glad I could help :)

[@Drmarwa213]

I'm pepraring for a test , and it was difficult for me to understand the interprétation of this score , but After i watched this video it's very clear and easy ❤️ thank you

[@TFreemanJohnson]

What constitutes an "acknowledged expert" pathologist? Does the term have a specific meaning? Is there some sort of certification credential to look for? If my surgeon says "Oh yeah, it was read by the best guy in the biz." Should I be satisfied with that assertion?

[@confidentlylost7215]

Thank you so much for the comprehensive explanation sir

[@ampscomm]

Great information. Thank you.

[@Canucksway]

1. Fruits with lycopene - tomatoes, grapefruit, papaya apricots, watermelon, etc. 2. Fish & fish oil (Omega 3) 3. Citrus fruit - oranges, lemons 4. Nuts containing Zinc - cashews, peanuts, almonds 5. Brazil nuts (Selenium), vitamin D (salmon) or supplements 6. Olive oil, avocados and its oil, pistachios, dark chocolate 7. Allium vegetables: garlic and onions

[@shreyasadhu8990]

So crisp and to the point ! Thanku 😀

[@catfish24]

Thank you for your knowledge and expertise in this field. I just had a prostate biopsy with 21 core samples and 2 of the samples came back positive my urologist said my Gleason score was a 6 He said i was more likely to be hit and killed by a car than for this score of 6 to do any harm. So he recommended just to keep monitoring me closely.

[@唬爛魚]

Fighting !!!!

[@cfurrati]

Congrats! Your video answered my doubts. Very good material. Watching from Brazil

[@ThePCRI]

Thank you for letting us know!

[@chinchchinch9918]

How are you doing now ?

[@elsiethomas8793]

Can the PSA reading guide regarding the Gleason score being 4+4=8 or 4+5=9. Will PSA reading be high or low if the gleadon score is low?

[@jamesadamgleason9471]

37yo Male with an enlarged prostate. I'm searching for answers and then this pops up. My last name is Gleason, I'm officially scared.

[@pluedemann1]

Thank you Dr. Scholz for a very informative video. The way you presented the info was excellent and answered many of questions I had.

[@tonyroma7599]

thank you for putting this information out there.👍

[@cattymed4419]

thank you,,,, bailey and love was getting pretty confusing for me

[@adk346]

Wow! Someone finally explained that! Thank you!

[@TheMegaKidBoy]

Thank you! Very clear explanation.

[@jefffarrenkopf2847]

Excellent info!

[@clowie299]

good video

[@surpenc]

Thank you doctor i hsd psa may 6.6 mri showed area concern gad biopsy 3 spores from area concern showed no cancer 19 spores random all cancer free apart from 1 which had gleeson 4+4 .decided on monitoring 3 monthly psa test just had my first and psa risen to 8.2. Recommend to see if next 3 monthly test shows rising, if does decide what action to take. I'm 62,no symptoms at all.

[@calbob750]

So much focus on PSA numbers. The Gleason Score tells it like it is.IMO.

[@georgeschoombie4316]

I still don't understand it please explain it

[@kunsadimitrios8266]

Well explained, thanks so much Doctor.

[@PlastelAnimations]

Thank you that is very clear and helpful !

[@faragelabeidi186]

What's the best treatment for 3+3,grade I...., age 74,post open heart surgery, PSA 34 ng/ml

[@mrofnocnon]

Personally I would say none. What did you decide?

[@ibnjameel97]

Just Wow 🤩 ...Thanks a lot 😍

[@yb801]

thank you, doctor, you explained very well.

[@nicasiohernandez4099]

Thank u so much for excellent explanation

[@kihi2608]

Hi doctor First of all thank you for your information. My Gleason's is III+III=6 TOTAL PSA IS 9.3 FREE PSA IS 2.39 Transial zone:PIRADS 2 PERIPHERAL zone:PIRADS 4 PLEASE inform me for choosing what kind of treatment surgery or trapy .. Thank you so much for helping Dr. Age: 61 years

[@keshabnayak]

Did you under went any kind of surgery

[@kihi2608]

@@keshabnayak No i didn't went under surgery yet.last MY PAS decreasing from 9.3 to 6.o6

[@CheriRichards]

Excellent video thank you. A recent biopsy of a 58 year old loved one showed 8 of 12 samples tested positive. Gleason scores were: 1 @ 6; 5 @ 7 with 2 @ 8. Hence, we've been told it is an aggressive cancer. A subsequent full body bone scan with a nuclear isotope did not suggest the cancer has spread. We are very interested in obtaining a second opinion of these biopsy slides from a prostate pathology expert. Can you please advise on how we go about locating an expert to review these slides? We do like the Dr.'s we are working with though we want a completely independent second opinion from an expert. Thank you again.

[@ThePCRI]

Hello Cherise, thank you for sharing. Patient's often send their biopsy slides to Dr. Jonathan Epstein from John Hopkins University. He is an expert in prostate pathology. Here is Dr. Epstein's contact information: urology.jhu.edu/jonathanepstein/ pathology.jhu.edu/department/services/consults/urologic.cfm Also, here is an article he did for our website: pcri.org/insights-blog/2016/3/10/interpreting-a-pathology-report-15-biopsy-and-gleason-questions-answered-by-a-leading-pathologist?rq=Epstein

[@ga20904]

@@ThePCRI , good information I was about to ask the same question as to who can give a second opinion

[@DivorceSourceRadio]

Love everything about this channel. It's a shame you can't find this type of information at many urologists offices.

[@flmoseley8141]

I have a gleason score of 6 or Epstein 1. I've already had 2 biopsies that truly suck cause they dont put you under and then you ejaculate blood for 2 months. I was told by my urologist that they hardly call my prostate cancer a cancer and its non aggressive. I'm 60 and now they want to do another biopsy and my psa has gone down from 7 to a 5. My feeling is if I keep getting biopsies where they jab a needle in there 12 to 14 times sooner or later I'm gonna get an infection or they will inadvertantly prelease cancer cells in my body that would never have escaped the prostate in my lifetime. So I've cancelled that 3rd biopsy at least for now. Any thoughts on this?

[@larbearplays3904]

My psa went from a 3.74 to 3 months later a 6.28 and 2 months later a 9.74 One hospital wanted to remove prostate and would not allow me to decide on other treatment. I went to a national cancer specific hospital (Roswell) and they have giving me 3 options. 1) surgical removal, 2) radiation, and 3) chemo. I go in again in a few days for bone scan with and without dye in a few weeks. I already 100% am against surgical removal as I like you don't want it spreading due to surgical intervention. Let's just say "family history" has put the belief o the surgery causing it to spread and dieng of cancer firmly in my head. As for advise, go with your heart, beliefs, and input from knowledgeable sources. Mine has went from intermediate to aggressive. Sorry if I was of no help to you. However I wish you the very best outcome. 55 yrs old, diagnosed at 54.

[@velko8026]

How accurate is the blood test 4k score in Gleasons scale

[@RAZ112652]

Thank you for the very detailed explanation. However, the individual that reviews your videos should be careful of misspelled words in each of the subtitles for the various sections. I am a retired teacher and when I see such errors, it decreases the trust in the professionalism of the material presented.

[@ncvman]

Get mri first then target biopsy. The other way around is a waste of time. Dumb insurance may not cover mri first though.

[@tracycottrell5146]

Now I understand much less

[@anthonymiller6081]

I live in Australia so I'm not sure how different it is to the United States. It's now 2023 and I'm currently waiting to have a Biopsy done on my prostate. I'm not in the private health system (insurance) here in Australia unfortunately. I'm in the Govt public hospital system which is normally good and most private urologists work in both anyway. The only difference with private it you may probably choose who you want and probably get it done quicker. I can use the private specialist but I have to pay about $4000 here in Australia for a prostate biopsy but it's free in the Govt system. I might have wait 1,2, 3 or more weeks which is ridiculous considering it's important to know what your actually dealing with. Hope it's not like that in the USA

[@Canucksway]

Tomatoes are the fourth most commonly consumed fresh vegetable and the most frequently consumed canned vegetable in the American diet. There is emerging epidemiology data supporting the connection between increased tomato consumption and reduced risk for both cardiovascular disease and prostate cancer. Here we will summarize the nutrient and the phytochemical content of tomatoes and tomato products, and how these bioactive components might act together to modulate disease development. Recent animal studies have investigated tomatoes, lycopene, and prostate cancer using the N-methyl-N-nitrosourea and Dunning rat models. These animal studies also suggest that diets containing tomatoes may decrease the risk or the progression of prostate cancer. Due to the frequency and the extent of tomato consumption, the supporting epidemiological and animal data, which connect increased intakes with decreased cancer and cardiovascular disease risk, tomato's role in the American diet is of undeniable importance as part of a healthy diet.

[@robd2650]

I wonder how you can make sure your slides get read with the best expertise? I mean are the slides in you possession? Do you say to the place I don't trust the way you read the slides? I mean I agree with him, that this is probably an issue, but you wouldn't think this would be something you'd have to take into your own hands. You'd think if they're medicals professionals doing all of this, they're would be safe guards in place to make sure the readings are correct.

[@ThePCRI]

Rob, There are a few good options for second opinions on pathology, but Jonathan Epstein, MD, at Johns Hopkins is one of the most favored by Dr. Scholz. Here is a link to his second-opinion program: pathology.jhu.edu/patient-care/second-opinions/send Your medical institution should send the slides without you needing to handle them yourself, and they should not be too offended - some insurances and institutions actually require a second opinion just to be sure.

[@岡本良二]

i enjoyed your lecture before taking radiotherapy...THANK gods anyone who know you!

[@adjeiboateng6720]

Such an informative video. Thank you Dr Mark😊

[@AnsweringMusic]

What if someone had 12 samples cut, and out of those, only 3 showed cancer. But the 3 that showed were “high risk”. Is this still a good sign providing there were only 3 positive and 9 that didn’t not have cancer? What could the stage be? What is the chance of survival?

[@edwardbertorelli7358]

Great series of informative analysis..your commentary is enlightening..and your manner is open and welcoming. I've listened to most of your talks. Thanks... ..

[@bencamicia103]

Please talk about a Genomic Decipher score.

[@vladlungu3033]

The result of my Biopsy test is : total Gleason Score - 7 (3+4); Grade group - 2; total number ofcores : 12 ; Positive : 4 ; offered treatment : Radical prostatectomy, and Radiation therapy. I have one month for making of desicion, I am confused what to do ? Your opinion please, what vould you do in this situation?

[@ThePCRI]

Vlad, You are welcome to get in touch with our free helpline here: pcri.org/helpline

[@keshabnayak]

So what you have done. Are you good and healhty

[@majaarminovska8026]

Can i have your email for consultation, thanks 🙏

[@RAZ112652]

Thank you for the very detailed explanation. However, the individual that reviews your videos should be careful of misspelled words in each of the subtitles for the various sections. I am a retired teacher and when I see such errors, it decreases the trust in the professionalism of the material presented.

[@papaormsby874]

I would like a PSA score at what number does it leak to other places??

[@ThePCRI]

Hello, the patient advocate who runs our helpline may be able to help with your question. Contact us using this page: pcri.org/helpline

[@jayevans7894]

My father got diagnosed in feb this year, surgery wasn’t offered to him. He’s started hormone therapy and will start radium at the end of August. What will happen after he finishes radium?

[@jayevans7894]

Mike Tucker thank you for your reply mr tucker. Yes I mean radiation therapy but in the uk we shorten it to radium. I’m absolutely over the moon that your cured and get to live a long happy life. My father is 67 and I’m praying that this radiation will kill the cancer. I’ll let you know how he gets on. He starts end of August

[@ThePCRI]

Hello, our prostate cancer helpline may be able to ​help with your question. Please feel free to contact us here: pcri.org/helpline

[@Melody-285]

@Nomad just reading your wonderful post - I just lost a dear friend to prostate cancer - his had metastasized & it seemed like he went down so fast .... I hope you’re still good - warmest wishes to you 😊

[@andrewbayram765]

Good vid. My Dad got diagnosed then my older brother, then my younger brother. All 4 of us bloomed within a few years of each other. My Gleeson was a 3+4. My younger brothers was labelled as more aggressive. My older brother at this time was moving into the terminal phase. My dad had radio therapy and blazed through it all never missing a day at work(75 + years old). Ultimately due to my older brother dying and my younger brothers cancer being labelled more aggressive took the plunge and had my prostate removed. Things went well apart from the usual side effects of surgery. On follow up I was informed that my cancer had been of a more aggressive nature then my Gleeson score revealed. This was something not explained to me. Your video is spot on. Sometimes I question my decision to to do what others labelled as jump early and the lack of sensation and erections but knowing it was more aggressive then expected and having watched my older brother die horribly restored my faith I did the right thing.

[@ThePCRI]

Thank you for sharing your story, Andrew!

[@i.w.y.3846]

@john Heather Where can I go on the internet to read about !ROLLAND and his cancer cure?

[@walidsarwary]

Hi brother so your dad was diagnoses age 75 and than how old are you and your brothers whom got the cancer caz i am 36 and my father diagnosed age 70 but my older brother is 44 years old but he is fine and my other brother is 40 he has no symptoms i checked my prostate was fine should i be worried ?

[@Melody-285]

Andrew - how are you doing now ? Please don’t focus on what you’ve lost - if you’re alive with a reasonable quality of life, that’s what matters - I just lost a friend to prostate cancer and it was fast ....it had spread, but they were still saying it would be ok & 4 mos later, he’s gone -

[@theophilusfrancis6276]

@@walidsarwary ok

[@getmore3521]

Thank you 🙏

[@DedaAlshebani]

it was difficult for st 5th medical study

[@markbrown5117]

Thank u sir. U Rock.

[@khalidalhashmi709]

thanks nicely explained

[@razan.ag2]

Thank you so much

[@Mark-is6re]

Outstanding explanation of a complicated topic!

[@satvindermudan5006]

Is he using grade and score synonymously? Is that the correct interpretation?

[@Mark-is6re]

@@satvindermudan5006 Hi Satvinder. Yes, same idea, just altered terms slightly.

[@satvindermudan5006]

@@Mark-is6re ok I understand. But surely that just adds to the confusion not reduce.

[@rogerembry4777]

Psa 2.9 Gleason 9

[@foodislifesouthafricacapet3716]

Hi how far has yours spread? My husband a Gleason 9 but PSA 132 before hormone.. going back for PSA on the 1st August

[@King_Illuminaughti]

No I think we get it❣️🙏🏻

[@fook12345]

thank you sir❤

[@davetheman2615]

thanks doc

[@dingdong436.]

Thank you 😍

[@Dr.Crabsticks]

Could you score a prostate cancer 1+5 = 6? Or is 3+3=6 the “lowest” combination

[@ThePCRI]

Hello, our prostate cancer helpline may be able to ​help with your question. Please feel free to contact us here: pcri.org/helpline

[@jhodini]

"Other Inforamation in the Pathology Report" (3:49). Small typo, I believe. Does not reflect well when presenting such a serious subject.

[@ThePCRI]

Yeah, we noticed that but could not fix it without reuploading the entire video, which would make all of our other videos out of order. It was published when we had a smaller, busier, staff, so typos may have slipped through more often, but we will be updating the entire staging guide series in the near future, and we will remove this video. Until then, I hope the typo does not affect the quality of the information too much for you.

[@ToddErnst1999]

Maybe this sounds good to a medical student, but THIS IS KZbin! What do these numbers stand for?

[@stephaniewallace7369]

Come on You all need to come up with a better treatment. Making a man an eunuch is barbaric!

[@Invictus888]

Excellent Video!

[@keithwilson6060]

What if a minimal Gleason score of 3+3 is accompanied by a steady increase in PSA levels?

[@ThePCRI]

Hi, our prostate cancer helpline may be able to answer your questions and ​help you find helpful information. Please feel free to contact us here: pcri.org/helpline

[@cathum]

Prostate Cancer Research Institute: The helpline telephone is not available for Canada; thanks.

[@greyg1537]

Thankyou sir🙏