Prostate cancer - Gleason Score

A score of 2 to 4 is considered low grade; 5 through 7, intermediate grade; and 8 through 10, high grade.

A prostate cancer tumor with a low Gleason score typically grows slowly enough so that it may not pose a significant threat to the patient in his lifetime.

Staging the Tumor

After the gleason score has been determined, your physician will need to “stage” your tumor to determine the size and how far it has spread.  The two staging systems are the TNM and the ABCD.  The ABCD system is and older system and is not often used.

TNM

'T'umor relates to the extent of the primary tumor.  T1 is a tumor so small that it cannot be felt.  T2 is a tumor that can be felt but it is still confined to the prostate gland.  T3 is a tumor that has broken through the prostate capsule and may have invaded the seminal vesicles.  T4 indicates that the tumors are growing into nearby muscles and organs.

'N'odes relates to the spread of the cancer into the lymph nodes.  N0 (zero) has not spread to the lymph nodes.  N1 has spread to one regional lymph node and is less than 2 centimeters.  N2 has spread to 1 or more regional nodes and is 2 to 5 centimeters.  N3 is greater than 5 centimers.

'M'etastases relates to the spread of cancer to other areas of the body.  M0 (zero) means the cancer has not spread and M1 means that it has.

You may hear the terms “Localized”, “Regional” or "Metastatic".  

• Localized - A T1 or T2 tumor confined to the prostate gland.
  
• Regional - A T3 tumor indicating that it has spread to the lymph nodes.
  
• Metastatic - A T4 tumor has spread to either the pelvic lymph nodes or other distant areas of the body.

If you have been diagnosed with cancer, seek a second opinion. Just as some accountants are better than others, some doctors are better than others.  They may be more aware of new treatments that your primary doctor did not know about.

One of the most important things to do is to locate a prostate cancer support group in your area.  By knowing your prostate cancer gleason score and the tumors stage, you may learning from other men how to deal with your diagnosis and treatment options.