What should you know about Gleason score prostate cancer?

A pathologist examines tissue from a prostate biopsy and identifies the two growth patterns seen most often. Each pattern receives a grade based on how different the cells look from healthy prostate tissue. The two grades are added to produce the Gleason score, often reported alongside a Grade Group. A higher grade indicates cells with more unusual organisation and may suggest a cancer that needs closer assessment. The score is one part of the picture; PSA results, examination findings, scan results, the amount of cancer in biopsy samples and your general health also influence decisions.

Ask for the exact two grades, total score and Grade Group in your report. Your urology team can explain whether the biopsy findings fit active surveillance, surgery, radiotherapy or another approach. Active surveillance may involve planned PSA checks, examinations, repeat imaging or another biopsy. If treatment is advised, discuss how it may affect urine control, erections and bowel function, and what support is available. Options can include [Prostate Removal Surgery](/treatments/surgical-oncology/prostatectomy/), [Radiotherapy](/treatments/radiation-oncology/radiotherapy/) or [Brachytherapy](/treatments/radiation-oncology/brachytherapy/).

Contact your clinical team promptly for fever, worsening pain, heavy bleeding or difficulty passing urine after a biopsy or procedure. Seek urgent help if you cannot pass urine, develop sudden severe weakness, or feel faint with ongoing bleeding. [Difficulty Passing Urine](/symptoms/difficulty-passing-urine/) can have several causes, so it needs assessment rather than an assumption about cancer.

Which grades and Grade Group are in my report? How much tissue contained cancer? Do my PSA, scans and biopsy findings point toward monitoring or treatment? Would a second pathology review change the interpretation? If treatment is recommended, what are the likely effects on urine, sexual and bowel function?