A biopsy only gets to about 1% of the prostate. As a result, a lot of different places are missing detection. About 30% of the biopsy Gleason scores are changed after a prostatectomy. I’ve heard From a number of people that have had their Gleason score changed from 3+4 to 4+5. Mine went from 3+4 to 4+3. Occasionally observers will even see people go from a 4+4 or 4+3 to a 3+4.

If you have radiation or focal therapy as your primary treatment, you never really know what your Gleason score is.

About 50% of the people that are on active surveillance find their Gleason score rises over time. My brother is a perfect example. He had a 3+3 And went on active surveillance for about six years, At that point, he was a 3+4 and a 4+3 And he had SBRT radiation to the prostate. I know of many other people that have had their score go from 3+3 too much higher numbers.