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Prostate Cancer: Grading

To form your treatment plan, your healthcare team must learn more about your cancer. What do the cancer cells look like? Has the cancer spread beyond the prostate? Cells removed during biopsy will be viewed under the microscope. Treatment will depend on how the cells look (grade) and where they are located (stage).

Grading the Cancer

A cancer is graded using tissue removed during a biopsy. A pathologist (a doctor who identifies diseases by studying cells and tissues) looks at this tissue under a microscope. He or she then determines the cancer’s grade, from 1 to 5. Low-grade cancers are similar to normal tissue. High-grade cancers differ from normal tissue in the way cells are organized, and in cell size and shape. The higher the grade, the faster the cancer is likely to be growing. The pathologist will give a report to your urologist.


Grade 1 or 2

Seen under a microscope, grade 1 or 2 cells are abnormal, but still appear to be organized in rings. This may indicate a slow-growing cancer.

Grade 3 or 4

Grade 3 or 4 cells vary more in size and shape. Fewer rings are visible. These cancer cells may grow more rapidly.

Grade 5

Grade 5 cells don’t form rings. They vary even more in size and shape than lower-grade cells. This indicates a fast-growing cancer.


The Gleason Score

Often there is more than one cancer grade within a tumor. The two most common grades found in the tumor are added together to get the Gleason score (or sum), a number between 2 and 10.


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