Knowing the prostate cancer stage and grade will help your treatment team decide what treatment options are best for you.

What is prostate cancer grading?

The grade of the cancer describes what the cancer cells look like compared to normal cells.

This tells the treatment team how quickly the cancer is growing and the risk that it may spread to other parts of your body.

Prostate cancer Gleason score

For many years, the Gleason scoring system has been used to grade the cancer cells taken during a biopsy.

The prostate cancer is given a Gleason score from six to ten. The higher the score the more likely the cancer cells are to spread through the body.  

ISUP grading system for prostate cancer

This new system grades the cancer betwee 1 and 5 depending on the Gleason score. 

The lower the grade the less likely the cancer is to spread.

This score helps your cancer treatment team plan your treatment.

ISUP
grade
Gleason
Score
Description
1 3+3=6 Cancer cells are likely to grow slowly
Note the difference between 3+4 and 4+3 which are both Gleason score 7
2 3+4=7 Most of the cancer cells look likely to grow slowly.
There are some cells that look more likely to grow at a moderate rate.
3 4+3=7 Most of the cancer cells look likely to grow at a moderate rate.
There are some cells that look more likely to grow slowly.
4 4+4=8 All of the cancer cells found look likely to grow moderately quickly
Note the difference between 4+5 and 5+4 which are both Gleason score 9
5 4+5=9 Most of the cancer cells look likely to grow moderately quickly.
There are some cells that are likely to grow more quickly.
5 5+4=9 Most of the cancer cells look likely to grow quickly.
5 5+5=10 All cancer cells look likely to grow quickly.

 

 

What is prostate cancer staging?

The prostate cancer stage describes the cancer's size and whether it has spread to other parts of your body.

Staging is done using the Tumour, Node and Metatases (TNM) system.

Tumour (T) - describes the size of the primary cancer

Stage Definition
T1 The tumour can't be felt by the doctor or detected on ultrasound
T2 The doctor can feel the tumour but it does not appear to have spread beyond the prostate
T3 The tumour feels as though it has spread beyond the prostate into the surrounding tissue
T4 The tumour has grown into surrounding organs such as the bladder or rectum

 

T1 3 stages of prostate
T1-T3 prostate cancer
T4 prostate
T4 prostate cancer
Left: T1-T3 prostate cancer | Right: T4 prostate cancer
Left: T1-T3 prostate cancer | Right: T4 prostate cancer

Nodes (N) - the number of nearby lymph nodes that have cancer

Stage Definition
NX Lymph nodes cannot be assessed
N0 Nearby lymph nodes do not contain cancer cells
N1 There are cancer cells in the lymph nodes near the prostate
Nodes (N) - Prostate cancer has spread to lymph nodes
Prostate cancer in the lymph nodes
Metastasis (M) - Prostate cancer has spread to the bones
Left: Prostate cancer in the lymph nodes
Left: Prostate cancer in the lymph nodes

Metastasis (M) - if the cancer has spread to different parts of the body

Stage How far the cancer has spread
M0 The cancer has not spread to other organs
M1 The cancer has spread to other parts of the body beyond the pelvis

Prognosis for prostate cancer

The prognosis is the likely outcome of a disease. 

If the test results show prostate cancer, you may wish to speak with your treatment team about the prognosis.

The doctors will look at the type and stage of the cancer as well as your age and general health to give a prognosis, but no doctor can predict the exact outcome for you. 

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Last updated: April 7, 2021