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Staging and Grading

Once the diagnosis of prostate cancer hasbeen made the disease has to be staged andgraded. The stage refers to the extent andspread of the disease while the grade refersto the nature (aggressiveness) of theparticular tumor. Staging will determine theextent of disease and provide importantprognostic information that will influencethe management decisions.

Staging investigations - PSA - X-rays oflumbar spine and pelvis - Chest X-ray -Radionuclitide bone scan - MTI scan of pelvis

TNM Staging system

T stage (extent of primary lesion)

- T1 - tumor confined to prostate, notpalpable or visible on TRUS - T2 - tumorpalpable or visible on TRUS but confined toprostate - T3 - spread beyond the prostaticcapsule - T3a - extracapsular spread only -T3b - involvement of the seminal vesicles -T4 - invasion into rectal wall, bladder neckor pelvic wall N (Nodal) status - N0 -regional nodes not involved - N1 - regionalnodes involved by tumor M (DistantMetastases) - M0 - no distant metastases -M1 - distant metastases present

Grading

Grading refers to what the cancer looks likeunder a microscope. The most commonly usedsystem is the Gleason grade and score. Theglandular pattern is compared to that of anormal prostate and scored out of 5, where 1resembles a pattern very close to normal and5 resembles severely distorted glandulararchitecture. The two predominant glandularpatterns within the cancer are graded out of5 and the combined score calculated out of10. The higher the Gleason score, the moreaggressive is the tumor and the worse is theprognosis. Patients with cancers confined tothe prostate (T1 and T2) and no involvementof the lymph nodes or other organs (N0 andM0) are potentially curable by surgery orradiotherapy. Patients with disease beyondthe prostate are not curable.

With our next information ' we will informyou about the 'Risk factors for enlargedprostate' ' so you should have a look onthis site in the next 2 weeks! If you haveany question sends us your e-mail.

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