What is the Gleason score?
The Gleason Score, along with the PSA level and TNM classification, is used to determine the prognosis of prostate cancer. For this purpose, a biopsy (removal of tissue) is examined microscopically and the stages of the cell change are determined. To determine the Gleason score, the worst and most frequent values found in the tissue sample are added together.
The lowest degree of degeneration is 1 and the highest 5, so that in the worst case a Gleason score of 10 can occur. A Gleason score of > 8 is an indication of a rapidly and aggressively growing carcinoma. A low Gleason score, on the other hand, indicates a more favorable prognosis.The Gleason Score also provides an indication of the risk of recurrence of the tumor: With palliative treatment of prostate cancer (wait and see), mortality is expected to be less than 25% with a Gleason score of up to 6, 50% with a Gleason score of 7 and 75% with a Gleason score of over 8.
- Low risk with Gleason score up to 6
- Medium risk with Gleason score of 7
- High risk with Gleason score of 8 or higher
What is the PSA value?
The PSA value (= prostate specific antigen) is a cancer non-specific value for the prostate that is measured in the blood. It is a protein that is produced by the prostate and can provide information about cellular changes in the prostate. For example, the PSA value is used as a tumor marker, among other things.
As part of the annual prostate cancer screening, the PSA level is determined in the event of a suspicious medical history or palpation. However, the results should be assessed with caution, since an elevated PSA value (= >4ng/ml) does not necessarily indicate a tumor. Conversely, in a patient with prostate cancer, the PSA value may be within the normal range.
The PSA value is also easily manipulated, for example by mechanical stress or strain on the organ up to 48h before blood collection. These include, for example, palpation by the urologist, hard stool and constipation, cycling, sexual intercourse and, in particular, ejaculation. The value can also be increased by other influences that do not directly affect the prostate, e.g. a visit to the sauna or a hot bath before taking the blood sample. The PSA value can therefore be a guideline for a disease, but should definitely be supplemented by other diagnostics!
