Diagnosis

Diagnosis (Gleason Scores and Staging the Disease)




The Biopsy



During a biopsy, needles are inserted into the prostate to gather tissue using ultrasound imaging. It may cause some discomfort or pain, but the procedure is short, and usually hospital stays are not required

Gleason Grading and Gleason Scores

Prostate cells are constantly reproducing and dying and look the same as other Prostate Cells. But cancer cells look different, and the degree to which they look different from normal cells is what determines the cancer grade. "Low-grade" tumor cells tend to look very similar to normal cells, whereas "high-grade" tumor cells often do not resemble normal cells.

The Gleason grading system accounts for the five distinct patterns that prostate tumor cells tend to go through as they change from normal cells. The scale runs from 1 to 5, where 1 represents cells that are very nearly normal, and 5 represents cells that do not look normal at all

After examining the cells under a microscope, the pathologist looking at the biopsy sample assigns one Gleason grade to the most common pattern, and a second Gleason grade to the next most common pattern. The two grades are added, and the Gleason score, or sum, is determined.
It tends to predict the aggressiveness of the disease and how it will behave. The higher the score, the more aggresive the cancer is

Staging the Disease
Staging determines the extent of prostate cancer. Localized prostate cancer that the cancer has not spread beyond the prostate. Locally advanced prostate cancer means that most of the cancerous cells are still within the prostate(note: not all). In metastatic disease, the prostate cancer has spread outside the prostate.
A number of tests can be used to help determine the stage of disease. Eg, It be detected through CT scans, MRIs, or x-rays, or more through bone scans. It cannot be used to determine the stage of the disease, to guide treatment options, or to predict outcomes.
Metastatic often can be detected in the lymph nodes. Cancers that spread to more distant organs travel through the lymphatic system, a system important in fighting infection and disease. During a biopsy, or, lympth nodes will be examined for traces of prostate cancer tissues.