Last night at our support/education group, a new member told a story of getting a Gleason score of 9 from a pathologist at a highly respected local hospital. For months he researched and planned his treatment, and he had crossed off surgery and brachytherapy as they were strictly local therapies that would have given him low odds of success, mostly due to that Gleason score of 9. However, at one point he was persuaded to have the biopsy slides reread by an expert. That reading downgraded the Gleason score to 7,
and it also reduced the estimate of cancer found in the cores.
That rescoring completely changed his outlook. He rethought his therapy choices and chose robotic surgery. He is now doing very well in the post surgery period.
This illustrates once again the importance of having Gleason scores determined by an expert. Changes in scores are fairly common. (My own changed just a little, from a 3+4=7 to a 4+3=7.) Usually we are more concerned that our initial score may be too low, but overgrading also occurs. Both undergrading and overgrading can lead to unsound therapy choices.
Needless to say, our new member was delighted with the way things turned out.