Prostate Cancer Stages

 

Once prostate cancer has been diagnosed, more tests will be done to find out if the cancer cells have spread from the prostate to the other parts of the body. This process is called staging. Your doctor needs to know the stage of your disease to plan treatment.

• T1 refers to a tumor that cannot be felt during a digital rectal exam (DRE) nor be seen through imaging tests such as transrectal ultrasound (TRUS), but that is found by a biopsy.
•  T2 means that your physician may feel the cancer by a DRE and that biopsy indicates that the cancer remains within the prostate gland.
• T3 cancers have spread to the connective tissue next
  to the prostate and/or the seminal vesicles, but do not
  involve any other organs.
• T4 means that the cancer has spread to organs next to
  the prostate (other than the seminal vesicles).

Cancer Grade and Score (Gleason Score)

The Gleason Score reflects how abnormal prostate cells look under the microscope. Grading is done by a pathologist, who examines tissue taken from a biopsy. Abnormal-looking cells tend to grow and spread more quickly and may have a worse outcome. This is sometimes called a Gleason Grade or Score. A pathologist assigns a Gleason grade ranging from 1 through 5 based on how much the cancer cells under the microscope look like normal prostate cells. Those that look like normal cells are graded as 1, while those that look the least like normal cells are graded as 5.

Since prostate cancers typically have areas with different grades, grading is assigned to the two areas with the greatest density of cancer. The pathologist then combines two Gleason grades to determine the Gleason Score between 2 and 10. The higher the Gleason score, the faster the cancer is likely to grow and the more likely it is to spread beyond the prostate.