The Gleason Score is more than likely one of the first things your doctor will discuss if you have received a prostate cancer diagnosis. That’s because it’s used to explain the stage of prostate cancer you have. Let’s discuss prostate cancer, the purpose of the Gleason Score, how it is calculated, and why it is so important.
What is Prostate Cancer?
The prostate is a gland found only in males that lies just below the bladder and in front of the rectum. Prostates in younger men are about the size of walnuts but tend to become larger as they age. It serves two main functions in the body. The first is to secrete prostate fluid (one of the components that comprises semen) and the second is to help move the seminal fluid into the urethra during ejaculation with the use of muscles.
Prostate cancer occurs when the cells in the prostate gland begin to grow rapidly and out of control. Usually, it starts out growing slowly and stays within the prostate.
There are 5 types of prostate cancers:
Adenocarcinomas
Small cell carcinomas
Neuroendocrine tumors
Transitional cell carcinomas
Sarcomas
Chances are high that when you are diagnosed with prostate cancer, it is adenocarcinoma, which starts in the gland cells.
The other 4 types of prostate cancers are less common. Like all cancers, prostate cancer is graded to determine how aggressive and rapidly it is growing. No matter the type of cancer, all patients diagnosed are staged. This means assigning a grade that defines how aggressive the cancer is. For staging prostate cancer, the Gleason Score is the method used.
What is the Gleason Score?
The Gleason Score was first developed by Donald Gleason in the 1960s and is the grading method that is used to determine how aggressive a patient’s prostate cancer is. In most cases, prostate cancer is made up of cancerous cells with different grades. For this reason, each patient is assigned two different grades. The first grade refers to the most dominant grade of cancer cells and the second-grade refers to the second most common dominant grade of cancer cells found during the biopsy.
How Does Gleason Scoring Work?
If your doctor suspects you have prostate cancer a biopsy may be used to confirm the diagnosis and gain insight its characteristics. The two most dominant grades of cancer cells found in the biopsy are each given a score of 1 through 5.
For instance, a patient may be assigned a 4 and a 3. These two numbers are then added together to determine the Gleason Score which is a range of 2-10. In most cases, oncologists never assign a Gleason Score below 6. If we go back to our example, 4 and 3 would be added together for a sum of 7. This means 7 would the patient’s Gleason Score.
What Do the Different Gleason Scores Mean?
The Gleason Score is based on the aggressiveness of the prostate cancer. The lower the number, the closer to normal the cell tissue, and slower-growing the cancer is likely to be. Anything less than 6 is not considered cancer.
The Gleason Score is based on the aggressiveness of the prostate cancer.
The higher the number, the more aggressive the cancer and the more likely it is to spread. Let’s take a look at what the different scores mean:
Low Grade: Gleason Score = 6: This indicates that more than likely the cancer will be slow-growing and not very aggressive. Patients with these scores have the best prognosis.
Intermediate Grade: Gleason Score = 7: A score of 7 means that the patient has a 50/50 chance of having aggressive prostate cancer. If the patient received a primary grade of 3 and a secondary grade of 4, more than likely the cancer will grow slowly. However, if those numbers are reversed and the primary grade was 4 and the secondary 3, the cancer may be aggressive.
High Grade: Gleason Score = 8-10: A score of 8-10 means the cancer is aggressive and likely to grow and spread at a rapid pace.
Why is the Gleason Score Important?
According to a study conducted by the University of Geneva, the Gleason score correlates very closely with the clinical behavior of the cancer cells. This makes is a very important indicator of how the cancer will act – slowing growing versus aggressive.
It tells oncologists a great deal about the characteristics of the prostate cancer although it’s not the only tool used to determine whether you need to move ahead with treatment. Other factors are used and evaluated as a whole. This can include one more of the following:
PSA blood test score
Physical examination findings
Imaging test results
Whether cancer was found on both sides of the prostate
Whether cancer has spread outside the prostate
Arizona’s Leader in Prostate Cancer Treatment & Research
Arizona Oncology understands that those facing a prostate cancer diagnosis are warriors. This is why our staff is comprised of compassionate caregivers to help you through every step of the way. When you choose Arizona Oncology, you can rest assured that you are receiving the highest-quality prostate cancer care available from highly experienced clinicians. Contact us today for more information.
11 common essential oils used in aromatherapy for managing cancer symptoms and side effects include:
Lavender: used to relieve stress, improve sleep, reduce inflammation, and treat depression
Eucalyptus: used to invigorate, reduce fever, and fight migraines and bacterial infections
Geranium: used to ease anxiety, reduce depression, and promote sleep
Tea tree (Melaleuca): can ease pain, reduce inflammation, and fight bacteria.
Lemon: used to get relief from pain, anxiety, nausea, and vomiting
Chamomile: used to soothe, promote sleep, and support the immune system
Bergamot: used to treat stress, anxiety, depression, and fatigue
Peppermint: used to boost energy, enhance mental alertness, fight fever, and relieve nausea and other digestion issues
Ginger: used to stimulate appetite and help ease nausea, vomiting, and bowel problems
Cedarwood: can promote relaxation and reduce stress
Frankincense: used to reduce inflammation and pain, boost immunity, soothe skin irritations, fight infections, and improve anxiety
For some cancer patients, treatment is a rough road to travel. This is why they often look for additional practices or products that can be used in conjunction with their standard cancer treatment to help manage cancer symptoms and treatment side effects. Treatments such as these are called complementary therapies. While there are many complementary therapies that can help, essential oils seem to have gained the significant attention for their aid in providing relief for cancer patients during treatment.
Essential oils are natural oils (compounds) found in plants. Once extracted, they possess the essence (fragrance) of the plant from which it was extracted. For many generations, essential oils have been used for the improvement of physical, emotional, and spiritual well-being. Aromatherapy is the therapeutic use of these oils.
When aromatherapy is used alongside standard cancer treatments to manage treatment side effects, patients often feel less stress and anxiety, which improves their overall quality of life. Certain oils can also aid in pain management. In many cases, aromatherapy is combined with other complementary treatments, such as acupuncture, yoga, and massage for symptom management. For a cancer patient, this additional support can be beneficial in their healing.
The effects of aromatherapy are theorized to result from the binding of chemical components in the essential oil to receptors in the olfactory bulb, impacting the brain’s emotional center, the limbic system. Topical application or aromatic oils may exert antibacterial, anti-inflammatory, and pain-relieving effects. This simply means that inhaling oils through the nose or applying oils to the skin can fight against harmful bacteria, reduce inflammation or swelling, and provide pain relief.
Each oil has its own specific health benefits, so patients must find the oils that work best for their specific health concerns.
Inhaling oils through the nose or applying oils to the skin can fight against harmful bacteria, reduce inflammation or swelling, and provide pain relief.
How to Use Essential Oils
Keep in mind that because everyone has a unique body chemistry, oils work differently on an individual basis. For this reason, it may take time before you see an improvement in your symptoms. Once you do find the right oils, however, you can inhale them or use them topically.
Diffusion is the most popular method for inhaling essential oils. This is done with a home diffuser that distributes essential oil molecules through the air mixed with water. Another way is to inhale directly from the bottle.
Topically means that the oils are being directly applied to the skin. It is important to remember that essential oils are highly concentrated and must be diluted with a carrier oil before application. Olive oil and coconut oil are both great carrier oils that can help your body absorb essential oils properly. In addition to rubbing diluted oils onto your skin, they can also be added to a warm bath, to a hot or cold compress, or to a lotion or moisturizer.
In most cases, our oncologists at Arizona Oncology are very supportive of their patients using essential oils as supportive care for their general well-being as they go through cancer treatment.
Because certain oils can interact with chemotherapies and cause other types of problems, it is strongly recommended that patients connect with their oncology provider before using essential oils during their cancer treatment.
The holiday season is a time for giving, sharing, and spreading joy. For those undergoing cancer treatment, the warmth and comfort of thoughtful gifts can make a significant impact. We’ve curated a list of gift ideas recommended by our staff and patients to bring a touch of festive cheer to someone you care about who is on a cancer journey.
Warm Blankets
As the winter chill sets in, a soft and cozy blanket becomes a cherished companion. It provides warmth during hospital stays, treatment sessions, or quiet moments at home. Opt for blankets made of soft materials to ensure comfort, and select colors or patterns that resonate with the recipient’s taste.
Chest Port Access Shirt
A specially designed chest port shirt can make receiving chemotherapy treatments less stressful. These garments are comfortable, accessible, and stylish, and come in a variety of sizes and designs.
Small Art or Drawing Sets
Art therapy has been proven to alleviate stress and promote a sense of well-being. A small art or drawing set can provide patients with an outlet for their emotions, allowing them to find moments of joy and peace through the therapeutic act of creating.
Personal Care Items
Pamper cancer patients with personal care items such as soothing lotions, lip balm, and eye masks. These small luxuries can provide much-needed relief, especially during dry or uncomfortable periods induced by treatment. Opt for fragrance-free options to accommodate heightened sensitivities.
Gift Cards
Empower cancer patients with the freedom to choose by gifting them gift cards. This way, they can shop for essentials, entertainment, or personal items from the comfort of their homes, particularly if mobility is limited. Practicality meets thoughtfulness with gift cards to local grocery stores like Frys or Safeway. These cards can be used for food, groceries, or even gas, offering essential support during treatment periods when energy levels may be low.
Books, Music, Puzzles
Provide a welcome escape with books, music, or puzzles. Engaging the mind in these activities offers distraction and entertainment during treatment or recovery. Tailor your choices to the individual’s interests, whether it’s a captivating novel, a favorite genre of music, or a challenging yet beautiful puzzle.
Heating/Cooling Pads
Addressing pain and discomfort is crucial for cancer patients. Heating pads can provide relief for sore muscles or joints, while cooling pads offer comfort during moments of overheating. Many products can be used either for heating or cooling, depending on the needs of the moment.
Soothing Teas
Tea is not just a beverage; it’s a soothing ritual. Gift a variety of teas to cater to different preferences and therapeutic benefits. Herbal teas with calming properties or blends designed for immune support can be particularly thoughtful choices.
Journaling Books, Adult Coloring Books
Encourage self-reflection and stress relief with journaling books or adult coloring books. These activities provide an expressive outlet for emotions and thoughts, offering a therapeutic escape during challenging times.
Entertainment Subscriptions
Give the gift of entertainment with subscriptions to streaming services, audiobook platforms, or e-book services. Cancer patients often spend extended periods in waiting rooms or recovering at home, making these subscriptions a fantastic way to provide distraction and enjoyment during downtime.
Meal Delivery Services
During treatment, energy levels may be low, making meal preparation a daunting task. Gift cards or subscriptions to meal delivery services can provide cancer patients with nutritious and convenient meal options, easing the burden of cooking and ensuring they receive the nourishment they need. These services can also help ease the burden on families with numerous mouths to feed.
Cancer Care Box
Having a hard time choosing a gift? Consider creating a comprehensive Cancer Care Box. Fill it with a combination of pampering items, aromatherapy, entertainment, and throw in a pair of comfy socks to boot! This holistic approach addresses both physical and emotional needs, conveying a message of care and support.
These thoughtful and practical gift ideas are designed to provide comfort, joy, and a sense of normalcy to cancer patients, and they are all approved by our patients and staff! Don’t forget to include a note or card. Sometimes the warm wishes behind the gift are what mean the most. This season, as you spread holiday cheer, consider these heartfelt presents to make a positive impact on the lives of those navigating their cancer journey.
I was enjoying my very busy life as a radiation oncologist, in a relationship, running, going to CrossFit daily, and taking care of three dogs, when my world changed with a simple blood test.
At 3:30 in the afternoon on July 9th, I saw my last new patient of 2013, and was admitted to the hospital at 8 am the next day. I was diagnosed with acute lymphoblastic leukemia with multiple critical issues. I was not permitted to leave the hospital for 23 days. It took a village to come to my aid, providing care for my menagerie of pets, including the dogs and two cats, taking care of my house and assuming the care of all of my patients.
While I was in the hospital, I was not able to see my dogs (okay, I snuck out to the sidewalk a couple times, our little secret). After discharge, caring for my dogs gave me the necessary motivation to move, after losing muscle and strength during my stay in the hospital.
During my battle with cancer, my dogs encouraged me to keep going. My biggest challenge came when I received a stem cell transplant from my brother’s bone marrow. A much more brutal treatment than my initial chemotherapy, it included whole-body radiation and even stronger chemotherapy. During this treatment, I was confined to one floor of the hospital, barely leaving my bed, using a central line for all food and fluids. Upon discharge, my dogs’ presence was immensely critical to me getting better.
The treatments that I endured left me very thin, and I felt cold all of the time. My dogs, making up for all of the attention they had missed during my illness, took every chance to pile on top of me which I was grateful for. They kept me warm.
I was so weak I could barely lift a grocery bag. I had so many people who helped me with the daily things I once used to do and took for granted, i.e. meal preparation, cleaning, shopping, etc. I, on the other hand, was a constant companion to my trusty four-legged friends, all of us being distracted only by an occasional nap. When it was time for a potty break they looked at me as if to say, “well, let’s go”! Their need to go out and get some exercise superseded my need to lay there in self-pity.
Fulfilling their needs helped me. In the beginning, it was only walking them, but it was a great place to start on my road to recovery. Continued walks lead to longer walks, and eventually back to running, and back to work, treating other cancer patients and helping them to get back to their lives. I got a little stronger every day, even stronger than I had been before my own cancer diagnosis.
A recent article published in HealthDay News, “Walking the Dog, All the Way to Better Health” reports that your dogs may be more than your furry companion, and that new research suggests that they may also be an effective personal trainer. Dog walkers spend less time sitting which means they are spending more time being physically active.
Project leader Andy Jones said “Physical activity interventions typically try and support people to be active by focusing on the benefits to themselves, but dog walking is also driven by the needs of the animal. Being driven by something other than our own needs might be a really potent motivator and we need to find ways of tapping into it when designing exercise interventions in the future.”
In addition, studies have shown that owning a dog helps with your heart health by lowering anxiety, lowering blood pressure, reducing cholesterol, and decreasing triglyceride levels. A study in the journal Gerontologist found that older adults who walked dogs experienced “lower body mass index, fewer activities of daily living limitations, fewer doctor visits, and more frequent moderate and vigorous exercise.”
Other studies tell us that dogs also help with making people less prone to depression, isolation and loneliness.
Despite all of the health benefits, owning a pet can be a big responsibility that doesn’t work for everyone. A good option might be to help out at one of the local animal shelters, all of whom desperately need volunteers to help with exercise and companionship while the animals there wait for a “furr-ever” home. A real win-win!
Author: Curtis Mack, MD is a Radiation Oncologist at Arizona Oncology. Dr. Mack is board certified in radiation oncology by the American Board of Radiology. He is active on the board of Handi-Dogs, a non-profit organization dedicated to training service and therapy dogs for seniors and those with disabilities in Southern Arizona.
Although the terms “genetic” and “genomic” are often used interchangeably, they are actually very different. Learning more about the differences between them can help clear up some of the confusion we often see related to hereditary genes linked to developing cancer.
Genetic Testing
Genetics usually refers to the study of specific, individual genes and whether they are passed from one generation to the next. Cancer researchers have studied hereditary gene mutations (changes) that can play a role in the development of cancer.
Genetic tests are medical tests that look for certain inherited gene mutations. This allows the genetic counselor to understand if the person being assessed is at a higher risk for developing certain kinds of cancers – such as breast cancer, ovarian cancer, colon cancer, prostate cancer, or others.
People who go through genetic testing do not necessarily have cancer – now or in the past. A genetic counselor will help you decide if genetic testing could give you potential benefits, and if there is even a suggested family history that would make genetic testing worthwhile.
The presence of one or more of the following may suggest a hereditary cancer syndrome could be present and the patient or their family members may want to talk to a genetic counselor about conducting genetic tests.
Cancer that was diagnosed at an unusually young age
Several different types of cancer that have occurred independently in the same person
Cancer that has developed in both organs in a set of paired organs, such as both kidneys or both breasts
Several close blood relatives that have the same type of cancer (for example, a mother, daughter, and sisters with breast cancer)
Unusual cases of a specific cancer type (for example, breast cancer in a man)
The presence of birth defects, such as certain noncancerous (benign) skin growths or skeletal abnormalities, that are known to be associated with inherited cancer syndromes
Being a member of a racial/ethnic group that is known to have an increased chance of having a certain hereditary cancer syndrome and having one or more of the above features as well
Genomic Testing
Genomics refers to an organism’s entire genetic makeup (DNA), which is called a genome. In cancer patients, genomics addresses all the genes within the cancer, and how they’re interrelated within the cancer. This can determine more about how the cancer will behave.
With genomic testing, the genomic makeup of abnormalities, or mutations, within the cancerous tissue can be identified. This means that genomic testing is used for patients that have been diagnosed with cancer, versus genetic testing which is routinely used as a precaution for someone who has not been diagnosed with cancer, or in a patient with cancer to help prevent future cancers.
If the cancer care team can understand the genetic abnormalities that could be driving the cancer’s growth, they can often determine how aggressive the cancer is or whether it is likely to spread to other parts of the body or if the cancer has an actionable mutation, which is an abnormality in the genetics of the tumor cells for which there is either an FDA approved targeted agent or one that is currently in trial or part of a future trial. Where a DNA change or a genetic mutation is detected in a patient’s tumor, and genomic testing could be a valuable tool in helping your oncologist understand how well your cancer could be expected to respond to treatment. There are many new targeted therapies currently being invented, almost on a daily basis. Only cancers with certain targets respond to specific agents.
How Genetic and Genomic Testing Impact Cancer Care
Even though these types of tests are different, they can both have a positive impact on a patient’s cancer care and/or on a family’s ability to screen more carefully for cancers that have a hereditary link.
Understanding the genetic risks of a patient can help physicians detect cancer early when treatment is most effective as well as implement strategies that can help patients prevent or reduce their risk of developing cancer.
Understanding the genomic profile of a patient’s cancerous tumor allows physicians to administer a more precise (targeted) treatment if one is available.
Genetic and genomic testing is not for everyone. It is important to talk with your doctor or a genetic counselor to determine if you would be a good candidate for either type of testing. Arizona Oncology offers a High Risk Cancer Program to our patients who qualify.
Receiving an abnormal report on your screening mammogram can be scary, but it doesn’t mean you have cancer. It doesn’t even necessarily mean that you require a biopsy. In this blog post we take an in-depth look at what it means to receive an abnormal mammogram result, and what the next steps might look like.
What does “abnormal” mean on a mammogram report?
There are several reasons why your report might be abnormal.
· The images were unclear or missed some part of your breast tissue
· There is an area that appears different from other parts of your breast
· Imaging detected a suspicious-looking mass or calcifications
Additional testing may cause patients to worry, and the mammogram technicians try to avoid the need for it by being as thorough as possible during initial scans. But in some cases questions do arise, and additional imaging can verify that findings are benign or that there is indeed something concerning that needs to be followed up on.
It may comfort you to know that fewer than one in 10 women who are called back for additional testing are found to have cancer in their breast.
What Happens During Follow-up?
If the radiologist calls you back because of abnormal screening mammogram results, the next step is usually a diagnostic mammogram. The radiologist will guide the technician in capturing specific breast images, ensuring comprehensive coverage. You may also undergo a breast ultrasound or a breast MRI (magnetic resonance imaging) for a more detailed picture. MRIs can detect subtle changes that might elude detection in mammograms or ultrasounds. In the majority of cases, when the area in question is compressed and more closely scrutinized, it is no longer suspicious looking and is not found to be cancerous.
What are the next steps if the area continues to appear suspicious?
If suspicions persist, a biopsy will be performed. This still doesn’t mean you have cancer—the majority of biopsy results are negative. Nevertheless, a biopsy and subsequent analysis are the only way to rule out or confirm cancer.
What do the Results Mean?
It helps to understand your results and how your doctor interprets them. The Breast Imaging Reporting and Data System (BI-RADS) is used to describe what is found on a mammogram. A zero-to-six categorization helps doctors use a common language to describe findings:
Category 0: Incomplete. The radiologist requires clarification. Additional imaging tests are needed, typically a diagnostic mammogram with spot compression and/or different views. The radiologist may request previous mammogram results to compare to the new results. An ultrasound or MRI may be requested.
Category 1: Negative. Nothing new or abnormal was found. Breasts are symmetrical with no distinguishable masses, abnormal structures, or suspicious calcifications. Calcifications are deposits of calcium seen but not felt in the breast tissue. Microcalcifications are tiny calcifications that can become cancerous. They require additional testing as they can become cancerous. Macrocalcifications are larger, coarser areas of calcium commonly found in women over the age of 50. They are the natural result of aging, past breast injury, or buildup that occurs over time.
Category 2: Benign or non-cancerous finding. This is also a negative test, however it is categorized differently because the radiologist records and describes the findings for doctors who will be looking at the report in the future. Recorded findings may be benign calcifications, masses, lymph nodes, or any changes from prior procedures.
Category 3: Probably benign. A finding in this category has no more than a two percent chance of being cancerous. The finding is not expected to change over time but can’t definitively be labeled as benign. Repeat imaging within six to 12 months and regularly thereafter is recommended until the finding is determined to be stable, usually over a period of two years. Category 4: Suspicious or abnormal finding. This finding may not be cancer, but it could be. A surgical biopsy (removal of a small sample of breast tissue) is recommended. There are three subcategories of suspicious or abnormal findings:
4A: Low likelihood of cancer (between two and 10% chance)
4B: Moderate likelihood of cancer (between a 10% and 50% chance)
4C: High likelihood of cancer (between a 50% and 95% chance)
Category 5: Highly suggestive of a malignancy. Your doctor believes this finding is cancer. It looks like cancer and has at least a 95% chance of being cancer. A biopsy is very strongly recommended.
Category 6: Known malignancy proven by biopsy. This describes a finding that has already been determined to be cancerous. At this category level, imaging is being used to monitor the patient’s response to treatment.
What role does breast density play?
Dense breast tissue has a high composition of glandular and fibrous connective tissue and a relatively low percentage of fatty tissue, which can make mammograms more difficult to interpret. Dense breasts are common, and almost half of all women over 40 have them.
Women with dense breasts may be asked to return for follow-up testing more often than women with fatty breasts.
There are four BI-RADS breast density categories:
Category A: Least dense
Category B: Scattered areas of dense tissue
Category C: More density (heterogeneous density)
Category D: Extremely dense
If your breast tissues are in Category C or D, ask your doctor about whether additional testing is recommended.
The Wait
Waiting for additional results can be unnerving, but most follow-up tests show normal tissue or a benign condition. Try not to worry. Talking with loved ones or other women who have had screenings or biopsies can be helpful. And always speak with your doctor if you have any questions about your findings or screening/testing recommendations.
