Prostate Cancer With Gleason Score 9: What's the Survival Rate & Prognosis?
If a person has an "aggressive" prostate cancer with a Gleason score of 9, what does that mean? What's the outlook when it comes to survival rate and prognosis.
Every cancer survivor is unique, of course, and people should only take medical advice from their doctor. However, there is a lot of research about prostate cancer, which is a common cancer men face, and the prognosis for it.
Former President Joe Biden has been diagnosed with just this form of cancer, according to CBS News. Biden's office said in a statement that he was diagnosed with "prostate cancer, characterized by a Gleason score of 9 (Grade Group 5) with metastasis to the bone." The statement noted, according to CBS News, that this is a "more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management."
Prostate cancer "develops in the prostate gland, a part of the male reproductive system. Many people choose active surveillance (no treatment) because prostate cancer tends to grow slowly and stay in the gland. For cancers that grow fast and spread, common treatments include radiation and surgery," according to The Cleveland Clinic.
First of all, what is the Gleason score? "The Gleason score is a grading system used by urologists to assess a prostate cancer’s aggressiveness based on how cells from the tumor look under a microscope," Fox Chase Cancer Center explains. "Less-aggressive tumors are more likely to resemble healthy prostate tissue. More-aggressive tumors look less like normal tissue."
According to that site, "The higher the Gleason score, the more aggressive your cancer is likely to be—and the greater the chance that it will spread."
The score is determined by grading each area "on a scale of 1 to 5, and the two numbers are added together to get the Gleason score." A Gleason score of 9 is at the highest end, although one score, a 10, is higher, according to the site.
Why two areas? According to the American Cancer Society, "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 Society notes that six is the lowest grade generally given.
"Men with a Gleason score 8 cancer tend to do better than those with a Gleason score of 9 or 10 (even though they’re all 'high-grade' cancers)," according to The Society.
As for survival rate, a study explored Gleason scores with 9 or 10 in the journal of European Urology Oncology.
"The outcome measures of 347 men with a preoperative Gleason score of 4 + 5 and 119 men with a Gleason score of 5 + 4 were rather similar with 10-yr cancer-specific survival rates of 70% and 73%, respectively," the article says.
Another article in that journal says, "Of all men with a Gleason score of 9–10, 34% were alive at the end of follow-up, while 43% died of prostate cancer and 23% died of other causes." The article noted, "The risks of death from prostate cancer in men with Gleason score 9–10 at 5 and 10 yr were used as endpoints."
John Hopkins Medicine stresses, "It’s important to keep in mind that survival rates and likelihood of recurrence are based on averages and won’t necessarily reflect any individual patient outcome."
According to that site, "Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized (spread) beyond nearby areas to lymph nodes, organs or bones in other parts of the body."
In general, prostate cancer is common and often treatable, the clinic wrote. "Prostate cancer is common, second only to skin cancer as the most common cancer affecting males," The Cleveland Clinic reported.
"According to the U.S. Centers for Disease Control and Prevention (CDC), for every 100 males, 13 will develop prostate cancer at some point in their lives. Most will live normal lives and eventually die from causes unrelated to prostate cancer. Some won’t need treatment."
About 34,000 people in the U.S. die from prostate cancer each year, The Cleveland Clinic says.
Still, approximately 34,000 people in the United States die from prostate cancer each year.