Staging and Grading

Gleason Score

Gleason Grade The pathologist rates the two most common types of cancer cell present in the samples, numbering each type from 1 for the least affected up to 5 for the most affected.

Gleason Score Aggressiveness of prostate cancer
2-4 Low
5-6 Moderate
7 Intermediate
8-10 High

A score of 2 to 5 indicates the cancer is relatively slow growing and probably not very aggressive. A score from 5 to 7 indicates the cancer is faster growing and moderately aggressive. A score of 8 or higher indicates an aggressive cancer.

Stage - or how far the cancer has developed.

  • Stage 1 - the cancer is small and contained within the prostate.
  • Stage 2 - the cancer is larger and may be in both lobes of the prostate, but is still confined to the organ.
  • Stage 3 - the cancer has spread beyond the prostate and may have invaded the adjacent lymph glands or seminal vesicles.
  • Stage 4 - the cancer has spread to other organs, or to bone.

Note: each stage has up to 4 sub-groupings (a, b, c, & d) for more accurate definition. Frequently the letter “T” (for tumour) is placed before the stage number, which then appears, for example, as T2(c), or similar. If in doubt, ask your doctor to explain the meaning to you fully. It is vital information for you to understand.

If you have the misfortune to be diagnosed, be sure to ask your doctor for the exact grade and stage of your cancer and discuss their meaning and implications. Be sure to note this information for future reference, as stage and grade are important indicators when choosing treatment. Your doctor may call for additional tests like a bone scan, CT scan and a MRI to check the extent of the disease.

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