He told us to go to a cancer institute. PMC How much of each core is made up of cancer, Whether cancer was found in both sides of the prostate, Whether the cancer has spread outside the prostate. Patients were retrospectively identified for inclusion by clinically localized disease, GS7, prostate-specific antigen (PSA) < 30 ng/mL at diagnosis, and follow-up with PSA at > 12 months. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Albertsen and associates6 examined the survival of men 6575 years of age who had clinically localized prostate cancer, comparing those treated with hormonal therapy with aged-matched, untreated controls. The median progression-free survival in patients with minimal disease is about 2 years and in extensive disease about 18 months. As a last thought, remember that being diagnosed with prostate cancer is not a death sentence. All that these really mean is that there is a different variety of options for the PT and the Uro to take their pick from. One of the major problems with the Gleason score is that some scores can be made up in different ways. Overtreatment is an issue because radical prostatectomy and similar therapies often cause side effects, Bill-Axelson said, most commonly erectile dysfunction and urinary leakage. This is most often caused by hormones or radiation therapy to the prostate. For individuals with known prostate cancer this is no longer relevant. In this example, the predominant grade is pattern 3, the secondary grade would be pattern 4, and the Gleason Score or sum would be 7. Cancers with a Gleason score of 7 can either be Gleason score 3+4=7 or Gleason score 4+3=7: Cores may be samples from different areas of the same tumor or different tumors in the prostate. The lowest Gleason grade is 1 and the highest is 5, so theoretically Gleason scores can range from 2 (1+1) to 10 (5+5). T2c: The cancer has invaded both sides of the prostate. Prostate Cancer Decision Matrix. Copyright 2017 Association of Directors of Anatomic and Surgical Pathology, adapted with permission by the American Cancer Society. These number are added together to assign a Gleason score between 2 and 10. Doctors use the cancer of the prostate risk assessment (CAPRA) nomogram to help them predict the risk that prostate cancer will spread, predict the risk of dying from prostate cancer and make treatment decisions. Learn how we can help. The cancer has slightly changed. Gleason scores label the severity and stage of the prostate cancer. A T4 cancer is bad news, but probably would also have a higher Gleason score than 7. The decision to offer one treatment or the other must reflect a critical analysis of benefits and risks. Scores under 4 are very rare. Still, other factors are also important, such as: Grade Groups are a new way to grade prostate cancer to address some of the issues with the Gleason grading system. We will all die anyway, have faith in God. However, it is possible that the Gleason Score from your biopsy is lower or higher than the true grade. In some cases, inflammation may increase your PSA level, but it is not linked to prostate cancer. Here are the possible Gleason scores with pattern 4, in order from least aggressive to most aggressive: Gleason 3+4. My life after the Radical Prostatomy has been a living hell complete loss of interest in life due to urinary incontinence, impotence, and infertility. I was stupid enough to buy into his diagnosis and planned treatment (I didnt know that Radical Prostatomy was for localized cancer only, and not for curative purposes of metastasized cancer that had already spread). Since prostate tumors are often made up of cancerous cells that have different grades, two grades are assigned for each patient. Eur Urol. These groupings are not entirely accurate, since a Gleason score of 7 is made up of two grades: 3 + 4 and 4 + 3. Prolaris Score of 3.7, that is 39 percent of the high risk have a lowered . Gleason 7 can be treated and in almost all cases with complete success. Int J Radiat Oncol Biol Phys. Surgery, radiation, or active surveillance (depending on exact clinical profile). The lowest Gleason score is 6, which is a low-grade cancer. This is most often caused by hormones or radiation therapy to the prostate. The definition of low-risk prostate cancer used in the CCO guideline includes a Gleason score of 6 or less; a prostate-specific antigen (PSA) measurement of 10 ng/mL or less; and a stage of T2a or less. MeSH Treatment doesnt save lives. Finding any of these is not important if prostate cancer is also present. The usual cutoff is around 69 or 70, though the use of modern techniques is notching that upward slightly for men in good shape with a long life expectancy. The Swedish study was started so long ago that men didnt routinely get PSA tests to diagnose prostate cancer, as they often do today. 19 A major weakness of the Gleason system is the . Because the grade may vary within the same tumor or between different tumors, different samples (cores) taken from your prostate may have different Gleason Scores. The major issue depends on whether the cancer is still confined within the prostate (a T1x or T2x cancer), has just broken through the prostate (a T3x cancer) or has spread (a T4x cancer). The Gleason Score on a biopsy usually reflects the cancer's true grade. A total of 559 men were consecutively treated with RP and pelvic lymph node dissection. Early detection and early treatment are the best ways to ensure a successful outcome with prostate cancer. This is not actually the case at all. The https:// ensures that you are connecting to the 1999 Jul;54(1):111-7. doi: 10.1016/s0090-4295(99)00219-8. Free information. Today I am 65 and healthy. Because I'm so desperate I've checked out recently even prices in private hospitals nearby.My wife is trying to force me for earlier operation,even in private clinic. So too, what is a Gleason score of 7 mean? If prostate cancer is found on a biopsy, it will be assigned a grade. Although, is Gleason score the same as PSA? The higher the grade, the more abnormal the cells. Read Also: Wife Gives Husband Prostate Massage. I discussed this with my GP and was reassured that in my case, this delay was unlikely to cause any problems, but of course it added to my stress. Intermediate risk: stage T2b-T2c, Gleason score 3+4 = 7, Gleason grade group 2 or Gleason score 4+3=7, Gleason grade group 3, or PSA 10-20 ng/mL; High risk: stage T3a or Gleason score 8, Gleason grade group 4, . There is a perception among a lot of patients especially when they get diagnosed that having a high Gleason score of 8, 9, or 10 is essentially a "death sentence", regardless of how they get treated. Go to: http://www.yananow.org/display_story.php?id=1659. s with whom to communicate. For men with resistance to androgen the overall survival ranged from 8 months to 20 months depending on the extend of spread. Forgoing aggressive treatment is a form of gambling how do you know when the cancer cells will migrate from the prostate and metastasize. This is not actually the case at all. Gleason 4+4. Most cancers score a grade of 3 or higher. The American Cancer Society is a qualified 501(c)(3) tax-exempt organization. This means your cancer is likely to grow slowly and unlikely to spread. I also had a lady friend who was diagnosed with bone cancer and given 6 months to live. These include the clinical stage of the cancer, the prostate-specific antigen (PSA) level, and the appearance of the prostate cancer cells under the microscope (the Gleason score). If cancer or some other problem is found, it is often not in every core, so you need to look at the diagnoses for all of the cores to know what is going on with you. Grade Group (based on the Gleason score) is a measure of how likely the cancer is to grow and spread. A Gleason score of 7 is a medium-grade cancer, and a score of 8, 9, or 10 is a high-grade cancer. This grades the cancer between 1 and 5 based on your Gleason score. However, since Dr. Gleason's original classification, pathologists almost never assign scores 2-5, and Gleason scores assigned will range from 6 to 10, with 6 being the lowest grade cancer. . But those two years after his operation were hell for him. It is imperative to mention that the lifetime risk of developing prostate malignancy is 14% (1). When it affects the entire prostate gland it is called diffuse atrophy. A T3 cancer is more difficult to cure but far from hopeless. These 2 grades are added to yield the Gleason score . Typically, the highest (largest number) Gleason Score will be the one used by your doctor for predicting your prognosis and deciding treatment. This nomogram is based on: the PSA level. We can also help you find other free or low-cost resources available. I expect the next diagnostic stages for your husband are an MRI scan and perhaps a bone scan. But how much GP4 should a patient be worried about? When the needle is pulled out it removes a small cylinder of prostate tissue called a core. Grade Group 2: Gleason score 3 + 4 = 7. Cancers will score 6 or more. Bethesda, MD 20894, Web Policies Gleason score 3 + 4 = 7 (grade group 2), and. To reduce the risk of over-or-under scoring, multiple biopsies are usually taken from different areas within the prostate. One is a screening test with minimal side effects. To compare outcomes between radical prostatectomy (RP) or radiotherapy (RT) approaches for Gleason 7 (GS7) prostate cancer. Over the last 12 months, approximately 4,600 Quebecers were diagnosed with prostate cancer. Treatment options at stage 2 include: removing your prostate and possibly some surrounding lymph . This is called the Gleason system. The lower the Gleason score, the less likely the cancer is going to spread to the lymph nodes, bones or other organs. Urology 11 years experience. If a tumor is all the same grade , then the Gleason score is reported as 3+3=6. Although most often the Gleason score is based on the 2 areas that make up most of the cancer, there are some exceptions when a core sample has either a lot of high-grade cancer or there are 3 grades including high-grade cancer. Lets do the math: Per the USPSTF (a US government agency): A small benefit and known harms from prostate cancer screening and Only one man in 1,000 could possibly have a life saving benefit from screening. For GS7 prostate cancer patients, RT is associated with superior disease-free survival at 5 years compared to RP alone, without difference in disease-specific survival. If the cancer cells and their growth patterns look very abnormal, a grade of 5 is assigned. Today, roughly 20 percent of the men are still alive, although prostate cancer is generally diagnosed late in life. After 24 targeted biopsies from the 3T MRI, I had cancer in one core measuring 1mm in length (Gleason score 6) and Cancer in another core measuring 3mm in length (again Gleason score of 6. Read A prostate cancer survival guide by a patient and victim, Beware, the ugly truth. Kibel, the Brigham and Womens urologist, said the Swedish study has been central to our understanding of how we manage prostate cancer, for decades, and confirms that many patients benefit from aggressive treatment. I may sound pretty relaxed about it now, but I will admit it's worrying at the time. Gleason scoring combines two numbers and can range from 2 (nonaggressive cancer) to 10 (very aggressive cancer), though the lower part of the range isn't used as often. I would say that radical prostatectomy is aggressive treatment and that anyone who is diagnosed with prostate should seriously consider it. hetherington and deans funeral home niagara falls. The new grading system subdivides prostate cancer into five categories using pathological characteristics as described in the table below. Healthcare providers established grade groups to clarify the Gleason score system. Exclusive analysis of biotech, pharma, and the life sciences. Any man over 50, anyone concerned about cancer in general, dangers from clinical trials, injuries and deaths from medical mistakes, should read this document. Instead it groups cancers into localized, regional, and distant stages. 6 years of living hell and still keep going. Since prostate cancers often have areas with different grades, a grade is assigned to the 2 areas that make up most of the cancer. The American Cancer Society offers programs and services to help you during and after cancer treatment. Low risk: PSA <10 ng/mL, Gleason score < 6 and clinical stage T1c or T2a It's a shock to receive a cancer diagnosis, but a Gleason score of 7 is normally regarded as Medium risk and depending upon other factors is often curable. The prostate gland wraps around the urethra and lies in front of the rectum. I dont know what to do or who to turn to, I have to get away from this anguish, self loathing, and basically feeling hopeless and apathetic. Prostate Conditions Education Council 2023, 7208 S. Tucson Way, Suite 230 Centennial, CO 80112. Nearly 30 years after it began, a study of prostate cancer patients shows both that the disease will not cause harm to the majority of men who have it, and that aggressive treatment is warranted for men with an intermediate risk of spread. The first number assigned is the grade that is most common in the tumor. My life after the Radical Prostatomy has been a living hell complete loss of interest in life due to urinary incontinence, impotence, and infertility. A Gleason score 4+3=7 tumor is more likely to grow and spread than a 3+4=7 tumor, yet not as likely as a Gleason score 8 tumor. Atypical adenomatous hyperplasia is another benign condition that can sometimes be seen on a prostate biopsy. The grade of the cancer is based on how abnormal the cancer looks under the microscope. (Don't mention any hospital or doctorname here - it's against the T&C of the forum). Well keep all topic alert notifications available on your dashboard for 30 days, to make sure you dont miss anything. . Major factors in metastatic disease pointing to adverse prognosis at the time of diagnosis include : Extent of the disease, Gleason score of 8 to 10 and presence of bone pain are other important prognostic factors in metastatic prostate cancer. Many hospitals give both grade group and Gleason scores to avoid confusion until grade groups become more widely used. Improved biochemical outcome with adjuvant radiotherapy after radical prostatectomy for prostate cancer with poor pathologic features. A Gleason score of 7 is considered medium-grade cancer and Gleason 8 and above is high-grade cancer. Atrophy is a term used to describe shrinkage of prostate tissue . Overall, Gleason scores of 5 or lower are not used. Before . I'm not sure how it works in Scotland, but it's still worth having a chat with your GP. Typically, the highest (largest number) Gleason score will be the one used by your doctor for predicting your prognosis and deciding on treatment options. Results: 3 months of hormone therapy (NHT) was followed by Pd-103 implant to the . According to his diagnosis, I was given no more than 6 months , or as long as between 3 to 5 years to live because of my End Stage 4 Prostate Cancer. According to his diagnosis, I was given no more than 6 months , or as long as between 3 to 5 years to live because of my End Stage 4 Prostate Cancer. Conclusion: A prostate cancer survival guide by a patient and victim. Available Every Minute of Every Day. Some patients with low-volume, intermediate-risk disease (Gleason 3 + 4 = 7) may also be offered active surveillance. Cancer.org is provided courtesy of the Leo and Gloria Rosen family. The Gleason Score ranges from 1-5 and describes how much the cancer from a biopsy looks like healthy tissue (lower score) or abnormal tissue (higher score). There is a perception among a lot of patients especially when they get diagnosed that having a high Gleason score of 8, 9, or 10 is essentially a death sentence, regardless of how they get treated. government site. Prostate cancer dirty secrets, lies, exaggerations, deceptions, elder abuse, outdated testing and treatments. Cores may be samples from different areas of the same tumor or different tumors in the prostate. Theoretically, Gleason scores range from 2-10. Whether you or someone you love has cancer, knowing what to expect can help you cope. A PI-RADS 4 or 5 is equivalent to a Gleason 7 or more. For comparison, 233 women in their 60s would need to get a mammogram to prevent one of those woman from dying of breast cancer, according to a 2012 study. Reporting from the frontiers of health and medicine, You've been selected! I was given a 10-day notice, and rushed into getting the Radical Prostatomy done by my urologist, Christopher Campbell Hoag who partners with other urologist in a clinic located in North Vancouver, British Columbia, Canada. My psa dropped dramatically and for a few years was below 1 on hormone therapy alone. Low Gleason score (no more than 6) 80% of men with this profile probably have locally confined disease. 2018-08-17. For example, if the Gleason score is written as 3+4=7, it means most of the tumor is grade 3 and less is grade 4, and they are added for a Gleason score of 7. The term to stage a cancer means to describe the evident extent of the cancer in the body at the time that the cancer is first diagnosed. DAmico also highlighted what he called a pretty striking statistic: that just eight men needed to undergo treatment to save one life, according to the study. NCI CPTC Antibody Characterization Program. A Gleason score of 7 is considered medium-grade cancer and Gleason 8 and . A Gleason score 4+3=7 tumor is more likely to grow and spread than a 3+4=7 tumor, yet not as likely as a Gleason score 8 tumor. It might (or might not) be felt by digital rectal exam or seen with imaging such as transrectal ultrasound [T1 or T2]. A score of 7 means the cancer is intermediate, and a higher . But be honest,I prefer NHS. Each day, well check to see if new items have been published to the topics youre subscribed to, and well send you one email with all of the new items from that day. Most cases of prostatitis reported on biopsy are not caused by infection and do not need to be treated. Not all patients need these tests. I'm not pretty sure obviously that my prostate will be removed in April,I just guess. PSA is 6.9,bones scan in last month shown that they're free of metastasis so far. The men, who were younger than 70, had low- or intermediate-risk cancers, as judged by several factors, including blood levels of prostate-specific antigen (PSA) and Gleason score, a measure of . Even now, I get antsy each time I have a follow up PSA test! I am glad that you are able to manage your urinary incontince, erectile dysfunctions, or dry orgasm and still be happy about your life not many people have that strong encourage. Researchers evaluated a total of 639 men (mean age, 65.83 years) with clinical T1-T4, N0M0 biopsy Gleason score 9-10 prostate cancer. Stage 4 doesnt have to be a death sentence. The cancer has not yet spread outside the prostate. For this procedure, the doctor inserts a thin, hollow needle into the prostate gland. This is often repeated several times to sample different areas of the prostate. Men with positive bone or CT scans were excluded from implantation. The Gleason score is 7 to 8. Regardless, the ultimate interpretation needs to be through the lens of the patients values. Seven is the total of two scores, a three and a four, or a four and a three. my husband was given the awful news that his gleason score is 7 after a biopsy following psa 5. he is in his 50s. Most cases of prostatitis reported on biopsy are not caused by infection and do not need to be treated. They are open from 9am to 5pm Monday to Friday. I was not allowed a second opinion because there was no time left due to the fact that my cancer had already metasitazied into distant organs and bones but I had no symptoms, no pains or no blood in my urine or semen. The Kaplan-Meier method was used for disease control estimates. High-grade prostatic intraepithelial neoplasia (high-grade PIN)is a pre-cancer of the prostate. The PSA was still below 3 ng/ml. It is not important in someone who already has prostate cancer. This does not include deaths and injuries from other procedures, medical mistakes, increased suicide rate, ADT therapy complications, heart attracts, etc, caused by screening and treatments. All of these are terms for things the pathologist might see under the microscope that are benign , but that sometimes can look like cancer. A doctor at the University of Chicago Medical Center performs a robotic prostatectomy. Purpose: Gleason score (GS) system is one of the most widely used histological grading methods for prostate cancer (PCa) all over the world. If the cancerous tissue looks much like normal prostate tissue, a grade of 1 is assigned. In high-risk cases, the prostate cancer tissue looks very different from normal tissue. Frankly speaking,two,full month left,according to my knowledge Gleason 4 (+3=7) could caused a problem if my operation is far away.May be I'm wrong,but predominant cells 4 are quite dangerous in general. Given his age (62) and Gleason score (7), he was advised to have undergo treatment soon, and given a portfolio of options including surgery . Once diagnosed, men will go through understandable and normal reactions, such as fear, denial, anger, helplessness and feeling of loss of control over their life. GS was 6 in 1304 (65.8%), 7 in 466 (23.5%), 8 in 142 (7.2%) and 9-10 in 69 (3.5%). Similarly, Gleason scores of 9 or 10 have a worse prognosis than Gleason score 8. The Gleason score is very important in predicting the behavior of a prostate cancer and determining the best treatment options. Grade group: 3 or 4; Gleason score: 7 (4 + 3) or 8; Treatment. The pathologist sends your doctor a report that gives a diagnosis for each sample taken. Kupelian P, Katcher J, Levin H, Zippe C, Suh J, Macklis R, Klein E. Cancer J Sci Am. When atrophy only affects certain areas of the prostate, it is called focal atrophy. She is alive and doing well. The pathologist sends your doctor a report that gives a diagnosis for each sample taken. Hi Kitkat, i was Gleason 9 with psa 1730 when diagnosed 8 years ago at the age of 47. Your PSA is actually low when compared to others, and from what you have posted elsewhere, your cancer stage is probably T2a, indicating it's organ confined and hasn't spread. Please enable it to take advantage of the complete set of features! For instance, if the Gleason Score is written as 3+4=7, it means most of the tumor is grade 3 and the next largest section of the tumor is grade 4, together they make up the total Gleason Score. We then did another biopsy a year and 2 months later. I took part in stampede trial receiving chemo, zometa and hormone therapy. . This score tells doctors how likely the cancer is to grow and spread. A score of 7 indicates a medium-grade prostate cancer . Together they can be used to predict an individual's risk of prostate cancer recurrence. In addition to stage, doctors may use other prognostic factors to help plan the best treatment and predict how successful treatment will be. It's a shock to receive a cancer diagnosis, but a Gleason score of 7 is normally regarded as Medium risk and depending upon other factors is often curable. Most cases of prostatitis reported on a biopsy are not caused by infection and do not need to be treated. ANSWER: Gleason score indicates the grade of your prostate cancer. Grades 1 and 2 are not often used for biopsies most biopsy samples are grade 3 or higher. Removal is most common and also ends BPH symptoms as well. A primary grade is given to describe the cells that make up the largest area of the tumor and a secondary grade is given to describe the cells of the next largest area. It can work the other way, too, with the true grade of the tumor being lower than what is seen on the biopsy. 18 Several studies have tried to address this problem by subdividing Gleason score 7 into Gleason score 3 + 4 = 7 and Gleason score 4 + 3 = 7. In this case, it is important to know what is the primary grade, that is the score of the predominant area of the tumor. The nuanced results come from a new update to a landmark study, published Wednesday in the New England Journal of Medicine, that has followed 695 Swedish men since they were diagnosed with localized prostate cancer between October 1989 and February 1999. Of the factors related to prostate cancer that doctors take into consideration when deciding on treatment, Gleason score is probably the most important one. Radiation of some kind, especially Proton Beam. The next question, and the primary subject of this point-counterpoint discussion, is whether to offer radical prostatectomy or radiation therapy. Your pathology report will list each core separately by a number (or letter) assigned to it by the pathologist, with each core (biopsy sample) having its own diagnosis. It means that if you have a Prostate Imaging - Reporting and Data System score of 4 or more, you are more likely to develop a metastatic cancer. The score is the same, but there is a difference - more pattern 4 than 3 - and . Atypical adenomatous hyperplasia (which is sometimes called adenosis) is another benign condition that can sometimes be seen on a prostate biopsy. the Gleason score. However, other factors also contribute to determining the stage of prostate cancer, including: The Gleason Score is very important in predicting the behavior of a prostate cancer. Watkins JM, Mitchell DL, Russo JK, Mott SL, Tracy CR, Smith MC, Buatti JM. Finding any of these is not important if prostate cancer is also present. Yes there are side effects noted in this article, but they are manageable. What Does Gleason 9 & 10 Mean? The area of cancer cells in the prostate will also be graded. You can help reduce your risk of cancer by making healthy choices like eating right, staying active and not smoking. | Ask a Prostate Expert, Mark Scholz, MD, Life Expectancy Prostate Cancer Gleason 8, Cryoablation Success Rate For Prostate Cancer, Best Treatment For Intermediate Prostate Cancer, Life Expectancy Stage 4 Prostate Cancer No Treatment, Prostate Cancer Spread To Skull Prognosis, How Do They Treat Prostate Cancer With Radiation. This is not actually the case at all. At the American Cancer Society, we have a vision to end cancer as we know it, for everyone. Information in this report will be used to help manage your care. Pathologists grade prostate cancers using numbers from 1 to 5 based on how much the cells in the cancerous tissue look like normal prostate tissue under the microscope. Maybe it's worth discussing with your GP if there are any health probems that are likely to be flagged up when you have the pre-surgery assessment, which is usually a week or two before you get operated on. And live a short and miserable life after treatment. HHS Vulnerability Disclosure, Help Created for people with ongoing healthcare needs but benefits everyone. My question is. Lori63 Member Posts: 9. Your treatment options may include active surveillance, surgery and radiotherapy with hormone therapy. Surgery of some kind. Is a Gleason score of 9 a death sentence? Its also important to follow recommended screening guidelines, which can help detect certain cancers early. Because grades 1 and 2 are not often used for biopsies, the lowest Gleason score of a cancer found on a prostate biopsy is 6. Low risk: PSA <10 ng/mL, Gleason score < 6 and clinical stage T1c or T2a (27 replies) Gleason 8-10. This stage also has three . A lower-grade cancer grows more slowly and is less likely to spread than a high-grade cancer. Most cells look very different from normal. But combined with their Gleason score and maybe someday with a diagnostic MRI men should be able to figure out whether their cancer is advanced enough to warrant treatment, or to monitor it to make sure it isnt turning more aggressive, Bill-Axelson said. However, in about 1 out of 5 cases the biopsy grade is lower than the true grade because the biopsy misses a higher grade area of the cancer. Given a Gleason score of 7 or greater, the probability of dying of prostate cancer was 29%. At each step of the way you'll be expecting bad news whilst hoping for good news, and there will be some tears shed along the way. Widespread bone and lymph node mets. A prognosis depends on many factors, including: Dont Miss: Cryoablation Success Rate For Prostate Cancer. Adenocarcinoma is the type of cancer that develops in gland cells. Undertaking aggressive treatment is a difficult decision for a person to make, particularly younger people, but the risks in not undertaking this form of treatment can be devastating. Disease recurrence was defined as per contemporary society guidelines. Scoring a 7 means that the primary score (largest section of the tumor) scored a 3 or 4. Cancers with Gleason scores of 8 to 10 may be called poorly differentiated or high-grade. It is the most common type of cancer found in the prostate gland. EBRT is effective in painful bone lesions in advanced prostate cancer patients but not an ideal option if there are multiple lesions at different sites. As the cells become more differentiated (or more aggressive and progressed) the assigned Gleason number increases, so a 4 reflects a more advanced and aggressive disease pattern than a 3. You are definitely not alone in your fight against prostate cancer. tom86211 Francesca008. T2a: The tumor has invaded one-half (or less) of one side of the prostate. The objective of this study was to compare the survival outcomes of Gleason score 3+4 and 4+3 based on data from the Surveillance, Epidemiology, and End Results cancer registry database, and to investigate independent prognosis-associated factors and .
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is a gleason score of 7 a death sentence