What Does My Diagnosis Mean: Grading and Staging of Prostate Cancer?

Grading tells us how aggressive the cancer is, while staging shows how far it has spread.

Grading: The Gleason Score
The Gleason Score is a method used to determine the aggressiveness of prostate cancer. It ranges from 2 to 10, with higher scores indicating a higher risk of the cancer spreading.

The score is based on two components:

• Primary Gleason Grade: The most common tumor pattern, scored from 1 to 5.
• Secondary Gleason Grade: The second most common tumor pattern, also scored from 1 to 5.

The Gleason Score is the sum of these two grades. For example, a Gleason Score of 7 might be made up of a primary grade of 3 and a secondary grade of 4.

Staging: How Far Has the Cancer Spread?

Staging helps determine the extent of the cancer’s spread in the body. Two common systems are used:

1. TNM Staging System

T (Tumor): Size and extent of the primary tumor
– T1: Cancer cannot be felt or seen
– T2: Cancer is confined to the prostate gland
– T3-T4: Cancer has spread beyond the prostate

N (Nodes): Involvement of lymph nodes
– N1: Small tumor in one lymph node
– N2: Medium-sized tumor or multiple small tumors
– N3: Large tumor in one or more lymph nodes

M (Metastasis): Cancer spread beyond the lymph nodes
– M1a: Cancer has spread slightly beyond the nodes
– M1b: Cancer has spread to the bones
– M1c: Cancer has spread to other organs

Whitmore-Jewett Staging System
– Stage A: Cancer is microscopic and cannot be felt
– Stage B: Cancer is detectable but contained within the prostate
– Stage C: Cancer has spread to surrounding tissues
– Stage D: Cancer has spread to bones or other organs

By understanding grading and staging, men and their healthcare providers can better decide on the most appropriate treatment plan. Talk to your doctor about screening options, and take charge of your health.