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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.
Stage
T1-T1c Stage T2-T2c
 
Stage T3 Stage
T4
 
TMN
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Description of Staging
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T0
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No
evidence of tumour
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T1a
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The
prostate feels completely normal but cancer found while examining
prostate tissue biopsy for other reasons. Tumour involving 5% or less of the tissue being examined.
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T1b
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The
prostate feels completely normal but cancer found while examining
prostate tissue biopsy for other reasons. Tumour involving more than 5% of the tissue being examined.
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T1c
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The
prostate feels completely normal but cancer is found because of an
elevated PSA.
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T2a
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Cancerous
tumour involving only half or less of one prostate lobe.
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T2b
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Cancerous
tumour involving more than half of one lobe, but not both lobes of the
prostate.
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T2c
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Cancerous
tumour involving both lobes of the prostate.
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T3a
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Cancerous
tumour that has extended beyond the prostate into the capsule (the
covering on the prostate)
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T3b
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Cancerous
tumour that has extended beyond the prostate into, and through, the
capsule (the covering on the prostate).
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T3c
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Cancerous
tumour that has extended beyond the prostate and has spread to one or
both seminal vesicles.
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T4a
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Cancerous
tumour has spread to bladder neck and/or external sphincter and/or
rectum.
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T4b
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Cancerous
tumour has spread to additional areas close to the prostate.
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N0
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No
cancer in the lymph nodes.
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N1
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Cancer
has spread to a single lymph node
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M0
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No
distant metastasis (cancer spread)
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M1
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Distant
metastasis present in bone or elsewhere
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*Diagrams: Decision
Aid for Prostate Cancer Treatment Abbott Laboratories, Limited –
Oct.1999
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What is the
prostate? / What is
prostate cancer? / Will I
get prostate cancer? /
What
are the other diseases that affect the prostate? / What
are the symptoms of prostate cancer?
/ How
can I find out if I have prostate cancer? / I
have prostate cancer now what? /
What
is the grade and stage of prostate cancer? / Why
is it important to know the grade and stage of prostate cancer? / What type
of treatment will I get for my prostate cancer? / Watchful waiting
/ Surgery / Radiation /
Hormone
therapy & other treatment options / How
do I make a treatment decision? /
Glossary of terms
/ Sources
of support and further information
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488 Locust Street., Burlington, Ontario, Canada, L7S 1V2
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