When we define how a cancer progresses, we categorize it as:
Localized - Remains confined within the prostate.
Locally Advanced - Spread into the tissues surrounding the prostate.
Advanced - Spread to other distant parts of the body. (Metastasis)
When cancer is found in a biopsy, there are now two detection and staging techniques we use to help determine how to continue with prostate cancer treatment. The Gleason Score is used to determine a tumor's aggressiveness and TNM Staging to determine how far the cancer has spread.
The Gleason Score use two samples from the biopsied tissue to determine where the number of most cancer is located. The area with the most cancer is called the primary area and the area with the next highest amount of the cancer is called the secondary area. A grade from one to five will be assigned to each sample depending on their "differentiation."
(The ability of a tumor to mimic normal gland architecture.) This number indicates the possibility of how likely the cancer is to grow and spread.
When we add both grades together, this is called the Gleason Score. Scores from 2-4 the cancer is not considered aggressive, 5-6 is said to be mildly aggressive, 7 moderately aggressive and 8-10 highly aggressive.
The TNM Staging determines how far the cancer has spread. A stage of T1 means the tumor is microscopic, T2 the tumor is confined to the prostate, T3&4 it has spread to tissue adjacent to the prostate and N+ or M+ it has spread to pelvic lymph nodes, lymph nodes, organs or bones.
Now that the severity of the Prostate Cancer has been determined, what method of treatment will be recommended to the patient?