Patient Information

Understanding Results

Once a diagnosis has been made, the urologist will discuss different options with you. Each person has a different disease and different considerations must be addressed. There is no universal treatment for prostate cancer. Many factors are taken into consideration before selecting a treatment. The Gleason Score and staging system are two that are reviewed. An individual’s age and overall health play an important role in decision-making. It is generally a good idea to bring along a friend or family member who can help with the listening and interpretation. There are multiple options available and you are an intergal part of the decision-making process.

Prostate cancer is often a slowly progressing cancer so there is usually time to explore all recommended options before making a final decision. There is a variety of treatment options including radiation therapy, surgical treatment, cryotherapy, medical therapy and in some instances, observation. Recently chemotherapy has been playing a more active role in the treatment of advanced prostate cancers. Often times a treatment plan is individualized by combining several types of treatment to improve the outcome of more aggressive tumors. All forms of treatment have some side effects.

Tumor Grade

If you have recently been diagnosed with prostate cancer, one of the first questions you want an answer to is “how bad is it?” Prostate cancers are evaluated by the Gleason Score. The tissue is examined under the microscope and cell patterns are graded by how similar the cells are to normal glandular tissue. This scale ranges from 1-5. Cells in the Gleason 5 range are very abnormal, while a Gleason 2 is very similar to normal. The first number in the Gleason Score represents the majority of cells seen under the microscope, with the second number being the second most common type of cell. The Gleason Score is reached by adding together the two most common cell patterns together. The prognosis of the disease is not solely determined by the Gleason Score, but this is taken into consideration when a treatment plan is selected.

An example of a Gleason Score would be 3+4=7. This means the most predominant cell type is a 3. The second most common cell type is 4. This relays this particular cancer is less aggressive than a 4+3=7.

A lower Gleason Score indicates a slower growing tumor which is more than likely contained within the prostate. Higher Gleason Score tumors are just the opposite. These tend to spread more rapidly and require a more aggressive treatment.

Tumor Stage

There is a difference between tumor grade and tumor staging. The grade determines how aggressive the cells are. The stage is a number assigned by the doctor after taking into consideration the location and extent of the disease. Consideration is given to the size of the primary lesion, spread to regional lymph nodes and the presence or absence of disease outside the prostate. The doctor evaluates any testing which has been done prior to assigning a stage to the disease. Stage I and II are contained within the prostate. Stage III is advanced to the tissue immediately around the prostate. Stage IV has spread beyond the prostate to other parts of the body.