Prostate Cancer

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Updated: March 28, 2007

About.com Health's Disease and Condition content is reviewed by V.K. Gadi, MD

Next Step- Evaluating Your Specific Situation

A physician uses many tools to diagnose and determine an individual's prostate cancer situation. Your cancer will be graded, staged, and a Gleason score obtained in order to determine the proper course of treatment based on your specific situation.

  • Tumor Grading--If a biopsy confirms cancer cells, those cells are studied to determine how aggressive they are. The samples are studied and compared with healthy prostate cells. The more difference that is found, the more aggressive the cancer cells tend to be. Years of study have allowed the pathologist to identify the cancer cells by size and shape. In the midst of all of the samples, he uses the two most aggressive types of cancer cells that he sees when assigning the grade.

  • Gleason Scoring--Biopsy samples are examined under a microscope by a pathologist to look for groups of cells making up tissue that is markedly different from healthy prostate tissue. The more different this tissue looks, the more likely the chance that it is malignant and will become aggressive and metastasize.

    The study involves two tissue samples for different areas of the tumor and gives each sample a score from one to five. The higher the number, the more abnormal the sample. The pathologist adds those two numbers together for that tumor to give it a number known as the "Gleason Score."

    Gleason Score Results--

    • 2-4 (well differentiated) = pretty normal tissue/mildly aggressive;
    • 5-7 (moderate differentiation) = moderately aggressive;
    • 8-10 (poorly differented) = very aggressive.

    Pathologists use the term "differentiation" to describe how normal a cancer cell is. If a cell is well differentiated, it is quite normal. A poorly differentiated cell suggests that the tumor will be very aggressive and require quick and aggressive treatment.

  • Prostate Cancer Staging--In addition to determining the level of aggressiveness of your cancer, the doctor also uses staging to classify how far your cancer has spread. Prostate Cancer is assigned four treatment stages based on how far it has spread:
    • Stage I: Early cancer that is confined to a microscopic area and the doctor and too small to feel when palpated by the doctor.
    • Stage II: The doctor can palpate the tumor, but it is confined only to your prostate gland.
    • Stage III: The cancer has spread to nearby tissues.
    • Stage IV: The cancer has spread to the lymph nodes, bones, lungs or other areas distant from the original tumor.

    Where To Go Next...

    The results of all of these tests is usually a "TNM Number," which specifically describes your cancer.

    Using the TNM system:

    • T (short for "tumor")--reflects the size of the primary tumor.
    • N (short for "nodes")--reflects the spread to regional lymph nodes
    • M (short for "metastasis")--reflects if the cancer has spread to a distant spot in the body.

    Complete information about TNM numbers can be found in the article, The TNM System for Rating Prostate Cancer.

    The TNM Number is used to identify a prostate cancer "Treatment Stage" that helps physicians choose the proper treatment for your specific situation.

    Recommended Reading: Prostate Cancer Treatments is a great next step to finding out more about treatments, the TNM number, and treatment stages.

    • Explore Prostate Cancer

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