5th post of this most recent context.
Incidentally, I've not included any illustrations of prostate cancer grading - only to ensure that I don't fall foul of copyright - these can easily be found by using your preferred search engine to find, say, 'Gleason grading of prostate cancer' and scroll down to 'Images'.
I've talked about Gleason 6 (3+3) and Gleason 7 (3+4), Groups 1 and 2 respectively, which are generally well differentiated cells. The former is clinically insignificant (it would probably be watched/monitored, rather than immediately treated) but the latter is (the first) of the clinically significant gradings, with more stroma/connective tissue, between the cells/glands.
I haven't referred to the numbers in brackets yet, but in essence these numbers reflect the smallness, uniformity, of the glands. Both of these, whilst positive for cancer, are relatively early grade (I may refer more to Staging at a later date, although if you look again to my first post in this context, where I've made reference to Sir Chris Hoy, you'll gather already that Stage 4 is when the primary cancer - in the prostate - has also spread to other tissues and become secondary cancer. Metastases to the bones is generally considered terminal).
If you do a search you'll pick up that a Gleason 7 (4+3 - NOTE it is still a Gleason 7 but the ordering has shifted from 3+4 to 4+3: the cancerous cells here are predominantly a higher Pattern 4 but there are also some lower Pattern 3's in the biopsy). This is a Group 3 cancer of the prostate. You'll see the uniformity of the cells is not so clear - there are in fact 'distinctly infiltrative margins' (this is how my OU module referred to it - the cells are predominantly undifferentiated).
There are three things then to think about with the classification of the grading of prostate cancer, the Gleason SCORE, the PATTERN of cells (from each core that is taken during the biopsy, a pattern is given, the first number represents the most frequently occurring pattern of cells in the core and to this is added the less frequently occurring pattern of cells - e.g.- (3 + 4)) and to this is added the GROUP (this is more up to date - but in my view it's unlikely that Gleason score will ever disappear from practice, it's too good). TOGETHER, these are all part of the GRADING.
On a Pathology report you might see the whole thing - GRADING - written like this: GROUP 2 GLEASON 7 (3+4), for example.
A Gleason 8 (4+4 or 3+5 or 5+3) are poorly differentiated with irregular masses of neoplastic glands. This is a Group 4 prostate cancer.
Neoplastic in the biological context: an abnormal mass of tissue. This came from the Greek for 'new formation'.
Gleason 9 and 10, each categorised as Group 5 prostate cancer, show only occasional gland formation. The cells are sometimes referred to as 'anaplastic'. These describe rapidly dividing cells with little or no resemblance to normal cells.
Next time: Evidence that supports the probability of at least some malignancy in the prostate by age range 70 to 80 (it's around 50%). This likelihood increases to approaching 70% at over 80 years of age - but many at that age will have had a less aggressive cancer, which may never need treatment. Another thing to bear in mind is that there are side effects to all treatments and whilst it is difficult to accept, one has to keep in mind average life expectancy (it can't last forever) and quality of life.
Many of us males (within the Harley fanbase) are in our 60's or even 70's now and that's why I've encouraged the male fanbase (those over 50 years of age - you see PSA tends to increase (slightly) naturally with age, even in the absence of disease and so even more reason to get tested) to seek a PSA serum blood test and a DRE. Each only take a few minutes...
Take care, stay your way,
It's coming up to the first anniversary of Steve's death and he (is) in my mind and I'm sure many of yours...
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