Donald Gleason
Encyclopedia
Donald F. Gleason, M.D., Ph.D. (November 20, 1920 - December 28, 2008) was an American
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 physician and pathologist, best known for devising the "Gleason score
Gleason score
The Gleason Grading system is used to help evaluate the prognosis of men with prostate cancer. Together with other parameters, it is incorporated into a strategy of prostate cancer staging which predicts prognosis and helps guide therapy. A Gleason score is given to prostate cancer based upon its...

" which predicts the aggressiveness of prostate cancer
Prostate cancer
Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize from the prostate to other parts of the body, particularly...

 in patients. He was a former chief of pathology at the Minneapolis VA Medical Center, and received three degrees from and taught at the University of Minnesota
University of Minnesota
The University of Minnesota, Twin Cities is a public research university located in Minneapolis and St. Paul, Minnesota, United States. It is the oldest and largest part of the University of Minnesota system and has the fourth-largest main campus student body in the United States, with 52,557...

.

Early life

Gleason was born in Spencer, Iowa
Spencer, Iowa
Spencer is a city in the state of Iowa , and the county seat of Clay County . It is located at the confluence of the Little Sioux and Ocheyedan Rivers. The population was 11,233 in the 2010 census, a decline from 11,317 in the 2000 census. Spencer is famous as the home of the Clay County Fair,...

, though he grew up in Litchfield, Minnesota
Litchfield, Minnesota
As of the census of 2000, there were 6,562 people, 2,624 households, and 1,653 families residing in the city. The population density was 1,748.4 people per square mile . There were 2,741 housing units at an average density of 730.3 per square mile...

, where his father, Fred Gleason, ran a hardware store, and his mother, Ethel, was a schoolteacher. He attended the University of Minnesota, and received his bachelor's degree, M.D., and Ph.D. from that institution. He entered the U.S. Army Medical Corps, serving an internship at the University of Maryland, Baltimore
University of Maryland, Baltimore
University of Maryland, Baltimore, was founded in 1807. It comprises some of the oldest professional schools in the nation and world. It is the original campus of the University System of Maryland. Located on 60 acres in downtown Baltimore, Maryland, it is part of the University System of Maryland...

 and training as a resident in pathology at the VA hospital in Minneapolis.

Career and test development

Gleason remained at the Minneapolis VA Medical Center after World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

. In 1962, Dr. George Mellinger, the hospital's chief of urology
Urology
Urology is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological...

, who was administering a cooperative research project involving fourteen hospitals, asked Gleason to develop a standardized pathological testing system to measure the development of prostate cancer. At the time, no single system existed to measure the speed at which prostate cancer spreads, nor was there a single system to describe the architecture of prostate cancer cells, seen under a microscope. While many classifications existed, but they were in practice difficult to apply, and pathologists would invent their own. This lack of a single standard led to confusion in patients' treatment and difficulties in evaluation of potential new treatments.

Gleason's technique, which he published in the journal Cancer Chemotherapy Reports in 1966, focused on two details of the architecture of the cancer cells, and assigned a score of one to five to each attribute. Thus, any given patient could have a score of between two and ten——the higher the score, the more aggressive the cancer, and the lower the chance of survival. Gleason found the score was directly related to survival rates in a study of 270 patients, which was the basis of his journal report. Subsequently, the relationship was confirmed in a study of 4,000 patients.

Dr. Akhouri Sinha, a colleague of Gleason's for forty years, described the scoring system as "comprehensive, yet simple so that the grading system can be used by pathologists, clinicians and scientists throughout the world". The scoring was adopted slowly until 1987, when several leading experts in the field recommended its use in all scientific publications regarding prostate cancer. The test became even more widely utilized following a surge in prostate cancers identified through a blood test, the prostate specific antigen
Prostate specific antigen
Prostate-specific antigen also known as gamma-seminoprotein or kallikrein-3 is a glycoprotein that in humans is encoded by the KLK3 gene. KLK3 is a member of the kallikrein-related peptidase family that are secreted by the epithelial cells of the prostate gland...

 (PSA) test. Today, according to Dr. Bruce Roth, a professor at Vanderbilt University
Vanderbilt University
Vanderbilt University is a private research university located in Nashville, Tennessee, United States. Founded in 1873, the university is named for shipping and rail magnate "Commodore" Cornelius Vanderbilt, who provided Vanderbilt its initial $1 million endowment despite having never been to the...

, "Every prostate cancer patient knows his Gleason score." Dr. Roth noted that it was remarkable that the Gleason score remained the standard in the profession, despite millions of dollars spent on attempting to develop molecular standards in an attempt to displace it.

Gleason rose to become chief of pathology at the medical center, and also taught at the University of Minnesota, with which the center is affiliated. He retired in 1986. In 2001, he received both the American Urological Association's Presidential Citation Award and an Outstanding Achievement Award from the University of Minnesota.

Personal and later life

Gleason was for many years a resident of Richfield, Minnesota
Richfield, Minnesota
As of the census of 2000, there were 34,439 people, 15,073 households, and 8,727 families residing in the city. The population density was 4,993.9 people per square mile . There were 15,357 housing units at an average density of 2,226.9 per square mile...

. Dr. Gleason died of a heart attack on December 28, 2008 in Edina, Minnesota
Edina, Minnesota
Edina is a city in Hennepin County, Minnesota, United States, and a first-ring suburb situated immediately southwest of Minneapolis. Edina began as a small farming and milling community in the 1860s. The population was 47,941 at the 2010 census.-Geography:...

and was survived by his wife, Nancy (to whom he was married for 62 years) and three daughters, Donna, Sue, and Ginger.
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