Diagnosis and Staging treatment options next steps Other Diseases of the Prostate
stage and grade of prostate cancer

 

I have prostate cancer – now what?

Once you have a firm diagnosis of prostate cancer your doctor, usually your urologist, will sit down with you to discuss the following eight issues:

Why is it important to know the grade and stage of prostate cancer?

The grade and staging of prostate cancer helps the doctor and patient determine which treatment will work best for the individual.  Complete staging may only be possible after surgery or additional tests and it may be necessary to remove some lymph nodes near the cancer to get an accurate picture.

The presence of cancer beyond the prostate has a major impact on treatment.  For patients at risk for spread, further staging tests should be undertaken before a treatment decision is made.  These tests may include a bone scan, CT scan or chest x-ray. 

What is the grade and stage of prostate cancer?

If you compare cancer to a house on fire, grade is the temperature of the fire and stage is the number of rooms that have been affected.

The grade of cancer refers to the microscopic appearance of the cells.  Once a biopsy is taken of the cancer, it is examined through a microscope.  It is assessed using the Gleason Pattern System.  The Gleason pattern is scored from 1 to 5.  1 is the most favourable appearing type of cancer and 5 is the least favourable.  It is based on the most common pattern in the cancer.  The 2 most predominant patterns are added to give a Gleason score out of 10.

The stage of cancer depends on its size and the extent to which it has spread to other parts of the body.  Complete staging may only be possible after surgery, or additional tests are complete, and it may be necessary to remove some lymph nodes near the cancer to get a true picture.

The actual stage of the cancer is described using a common TMN system.  It is a combination of letters and numbers that look somewhat like a postal code – T1N2M0 – when used.  The T stands for tumour, and the number following it indicates the size of the tumour.  The N stands for nodes, and the number following it indicates the extent to which the lymph nodes are involved.  The M stands for metastases, and the number following it indicates the amount of spread to other parts of the body.  For prostate cancer, metastases indicate the spread of prostate cancer to the bones in 90% of the cases.  Other sites of spread include the lungs and liver.

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