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===Management=== | ===Management=== | ||
====Dirty first approximation==== | ====Dirty first approximation==== | ||
*The management changes between [[Gleason score]] 6, 7 and 8. | *The management changes between [[Gleason score]] 6, 7 (3+4), 7 (4+3) and 8. | ||
Typically, the implications are: | Typically, the implications are: | ||
* Gleason 6: observation ''or'' radioactive seeds; surgery if patient wants. | * Gleason 6: observation ''or'' radioactive seeds; surgery if patient wants. | ||
* Gleason 7: do something -- surgery ''or'' radiation therapy. | * Gleason 7 with a bit of Gleason pattern 4 and a low tumour volume: it is reasonable to watch ''or'' do something. ‡ | ||
* Gleason 7 with a lot of Gleason pattern 4 ''or'' a high tumour volume: do something -- surgery ''or'' radiation therapy. | |||
* Gleason 8+: bad cancer -- do something quickly! | * Gleason 8+: bad cancer -- do something quickly! | ||
Bottom line: | Bottom line: | ||
*You want to be sure when you call something Gleason pattern 4. | *You want to be sure when you call something Gleason pattern 4. | ||
Note: | |||
* ‡ It has been said that ''Gleason score 7 with a bit of Gleason pattern 4 is the new Gleason score 6''. | |||
====Observational strategies==== | ====Observational strategies==== |
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