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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19335
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have been diagnosed with " adenocarcinoma prostate Gleason

Customer Question

I have been diagnosed with " adenocarcinoma prostate Gleason 9"
Please explain the implications.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.

An adenocarcinoma of the prostate is the common form of prostate cancer.

When assessing the prognosis for prostate cancer, the most important clinical issue is whether it is limited to the prostate or the amount of spread of the cancer. This is called the stage of the cancer. As with most cancers, if prostate cancer is found at a time when it is localized and limited to the prostate, the prognosis is much better. Since the tests appear to show no spread of the cancer, that is a very good sign, even with a high Gleason score.

The Gleason score is a measure of the amount of differentiation of the cancer, i.e., how much the cancer looks like normal prostate. Obviously, no cancer looks completely like the normal prostate, but if the cells look like they are trying to look like normal prostate structures, that is considered well differentiated and would be a low Gleason score. If the cells do not look anything like normal prostate structure, then it is said to be poorly differentiated and would have a high Gleason score. This is called the grade of the cancer.

Although the stage of the cancer is the most important determinant of prognosis, the grade also influences prognosis, so a cancer that is limited to the prostate with a high Gleason score will have a worse prognosis than another man with a similar stage but a lower Gleason score.

Doctors will also use the Gleason score when deciding on treatment. If there are a couple of options available for treatment of a certain stage, doctors are more likely to recommend more aggressive treatment if the Gleason score is elevated. For example, for localized prostate cancer, one of the options is a wait and monitor approach, but this is usually only considered when there is a low Gleason score. In a man with localized cancer and a high Gleason score, it is more common for the doctor to recommend treatment.

If I can provide any further information, please let me know.