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Tumor Evaluation and Staging

If cancer is found in your prostate, your physicians will need to know the tumor stage and tumor grade to determine which treatment options are most appropriate for you.

Tumor Stage
If cancer is found in your prostate, your physicians will need to know the tumor stage. Staging is a careful attempt to find out how large your cancer is, and whether the cancer has grown outside the prostate gland, or spread to other parts of your body. Blood work, the DRE, and various scans such as a CT scan, MRI scan, and bone scan can all provide valuable information regarding tumor stage. Your physicians will decide which studies are necessary. The stage of your cancer will strongly influence which treatment options are most appropriate for you.

Tumor Grade
The tumor grade provides important information regarding how fast the cancer is likely to be growing, and the likelihood that the cancer has spread to other parts of the body, such as the lymph nodes or bones. The pathologist assigns a grade to your tumor when he or she looks at the malignant cells under the microscope. The higher the Gleason grade, the more aggressive the tumor.

The most commonly used grading system is called the Gleason score. Each patient's tumor is assigned two grades that represent the major and minor patterns of malignant glands seen under the microscope. Each of the two grades will range from 1-5. The two grades are then added together to give a Gleason score (which ranges from 2 to 10). A Gleason score of 2 to 5 represents a low-grade malignancy. These tumors are usually slow growing, have a low likelihood of spreading, and are rarely fatal. Tumors that have a Gleason score of 8 to 10 are high grade, and are more likely to be fast growing or to have metastasized to lymph nodes or bones. Most patients have intermediate grade tumors or a Gleason score of 6 or 7.

These are medium growing tumors and the prognosis is generally good. The Gleason score strongly influences which staging tests are ordered and what treatment options should be considered.

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Holy Cross Hospital | 1500 Forest Glen Road, Silver Spring, MD 20910 | 301-754-7000