Prostate Cancer

Lesson 2: Prostate Cancer

Prostate Cancer Staging and the Gleason Score

"Staging" is a system used to describe the extent of the cancer. After a definitive diagnosis of Prostate Cancer, your doctor or health care practitioner will need to know how advanced your cancer is in order to determine a feasible treatment plan. Prostate Cancer is staged as follows:

T1 or A: there are no lumps or nodules that can be felt during a digital rectal examination.

T2 or B: there is a well-defined lump or nodule that can be felt during a digital rectal examination.

T2a or B1: the nodule is relatively small.

T2b or B2: the nodule is relatively large, but remains within the prostate.

T3 or C: the nodule has spread beyond the prostate into tissue surrounding the prostate.

T4 or D1: cancer cells have spread from the prostate and can be found in the lymph nodes, or beyond.

D2: the cancer has metastasized (spread) to other organs or bones.

To find a more comprehensive explanation of the grading system, go to: http://www.nccn.org

"Grading" is a way of further classifying the cancer. When a biopsy is done, and cancer cells are found, a Pathologist examines the cancerous cells under a microscope and compares them to normal prostate tissue. From this, the Pathologist can develop a score. This score can predict the cancer’s potential to grow and spread. Prostate cancer is graded using the Gleason system:

The Pathologist assigns a number (between 1 and 5) to each of the two most predominant patterns of cells present in the cancerous tissue sample. The two numbers are added together and the resulting sum is the Gleason score. A Gleason score can range from 2 to 10. The Gleason score determines the cancer’s growth potential:

A Gleason score of 2-6 (low score): The cancer cells are very similar to normal prostate cells, tend to grow slowly, and don’t tend to spread elsewhere in the body. A Gleason score of 7: The cancer is in between in its behavior and ability to spread.

A Gleason score of 8-10 (high score): The cancer cells are very different from normal prostate cells, tend to grow faster and have a greater chance of spreading through the body.

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