Understanding Staging and Grades of Prostate Cancer

A biopsy is needed to confirm that prostate cancer is present in your body. After the diagnosis is confirmed, it is classified into grades. All of this grading, staging, and PSA level can be confusing. We will try to help you make sense of the information you are being bombarded with.

First, PSA is a substance made in the prostate gland. The PSA level is usually low unless the patient has a higher count. A higher PSA level often signals a problem with the prostate and possibly cancer.

Cancers are graded which is a mark of the differences between the cancer cells and the normal cells. These cells are inspected through a microscope and graded on a “Gleason” grade. The Gleason grading system uses a range from 1 to 5. If your cancer is graded as 1, it means the cancer cells that are clustered together look like normal prostate tissue. If the cancer cells do not resemble normal cells at all, the grade could be a 5. Doctors will examine the two areas of the prostate that has cancer cells and grade them individually. Those grades are then added together and will be on a scale from 2 to 10. A low Gleason score means that your cancer is a slow growing cancer. If it is a high-grade, your number is high on the grading scale; it means the cancer could be more aggressive in its growth.

Staging is another measurement that your doctor will talk to you about. Staging is rating the size of the cancer and where it is found. It also will tell you if the cancer has spread to nearby lymph nodes, the bones, or other organs in the body. Staging is necessary so you and your doctor can decide how aggressive your treatment should be and which treatment is best for you.

There are two methods used to stage prostate cancer. There is a traditional method that classifies into four categories, A through D, and the second is TNM. This acronym stands for Tumor-Nodes-Metastases. The staging for the A-D method is:

– A is early cancer. It means the cancer is only found within the prostate gland and cannot be felt by a rectal exam.

– B is the stage when the tumor is found in the prostate gland and can be felt during a rectal exam.

– In Stage C, the cancer is more advanced and has spread outside the prostate to surrounding tissue. Stage C cancer has not spread to lymph nodes or other organs.

– Stage D is the most serious stage. It means the cancer has spread to the lymph nodes and other sites in the body. That can include the ribs, spine, or other bones or organs.

TNM staging is a little simpler method. It looks at the tumor stage (T), if the cancer has spread to the lymph nodes (N) and if the cancer has metastasized (M) to other sites of the body. Tumor stages are ranked as 1-4, lymph node involvement is graded N for zero, or 0-3. Metastasis is rated O or 1. MO means there has not been any metastasis and M1 means it has traveled to another location in the body.

 

Diagnosing Prostate Cancer

Prostate cancer is the second largest of all cancer related deaths in males; the only cancer that causes more deaths annually is lung cancer.

To stand a chance of combating prostate cancer it is important to have an early diagnoses, this way the medical professionals have a better chance of containing the condition and stopping the cancerous cells spreading to other parts of the body while also working to eradicate the illness altogether.

Before a testing or a diagnosis takes place a person needs to see there is a problem and seek medical advice, this may initially come in the form of pains while urinating, having difficulty passing urine, passing blood in the urine, urinating more frequently or having difficulty gaining and maintaining a full erection.

Once a person has seen there is a problem and looked for more medical help, the medical professionals will have to perform tests to find out if the problem is prostate cancer or another condition, these test can be carried out in a number of ways.

Digital Rectal Examination (DRE)

The prostate is located at the point where the urethra leaves the bladder, and it also sits against the outer wall of the rectum about 5 centimeters inside the anus.

Because of the location of the prostate a good examination can be made through the rectum, this is done by a medical professional who will use a well lubricated glove to insert a digit (otherwise known as a finger), into the anus and feel the inner wall of the rectum, by doing this they can actually feel the rear of the prostate located on the other side. Although it is only the rear of the prostate that can be checked it has been reported that 85% of all prostate cancers originate from this part of the prostate.

If the medical professional feels any unusual lumps or bumps it means they may require the person to have further tests.

Prostate Specific Antigen (PSA)

The prostate specific antigen test is a simple blood test, which is taken and tested for levels of the prostate specific antigen enzyme. By finding out the levels of PSA the medical professionals can see what the risk of cancer is. Below is a list of PSA levels and risks associated

– PSA levels of 4 nanograms or less per milliliter is healthy

– PSA levels above 4 nanograms per milliliter is a risk of prostate cancer

– PSA levels above 10 nanograms per milliliter extremely high risk of prostate cancer

There are flaws with this test though because as a man grows older the levels of prostate specific antigens increase naturally, which is taken into account by the medical professionals, also a large proportion of men with high PSA levels do not have prostate cancer and likewise a proportion of men with prostate cancer have low PSA levels.

Confirming the diagnosis

If the medical professionals believe there is a chance of cancer they will request that you have a biopsy where a small tissue sample from the prostate is taken. To take a biopsy of the prostate the medical professional will put a tiny needle gun in the anus and press it against the wall of the rectum where a hollow needle will pass through the wall of the rectum into the prostate and take a sample. This procedure is not very painful and is routinely done on an outpatient basis.

 

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