If you or someone you care about has recently been diagnosed with prostate cancer, this section will help guide you through the complexities of this diagnosis and other issues to consider.
Understanding Your Diagnosis
A doctor typically diagnoses prostate cancer after closely examining biopsy cells through a microscope. There are several types of cells in the prostate, and each contributes in its own way to the prostate’s development, architecture, and function.
But cancer cells grow in an uncontrolled way and look different than normal prostate cells. Pathologists look for these abnormal differences first to detect the presence of cancer and then to determine the cancer grade.
The Gleason grading system accounts for the five distinct patterns that prostate tumor cells tend to go through as they change from normal cells to tumor cells. The higher the score, the more aggressive the tumor.
The cells are scored on a scale from 1 to 5:
- “Low-grade” tumor cells (those closest to 1) tend to look very similar to normal cells.
- “High-grade” tumor cells (closest to 5) have mutated so much that they often barely resemble the normal cells.
The Gleason Score
The pathologist looking at the biopsy sample assigns one Gleason grade to the most predominant pattern in your biopsy and a second Gleason grade to the second most predominant pattern. The two grades added together determine your Gleason score (between 2 and 10).
Generally speaking, cancers with lower Gleason scores (2 – 4) tend to be less aggressive, while cancers with higher Gleason scores (7 – 10) tend to be more aggressive.
It’s also important to know whether any Gleason 5 is present, even in just a small amount, and most pathologists will report this. Having any Gleason 5 in your biopsy or prostate puts you at a higher risk of recurrence.
Terms to know from this article:
The removal of cells or tissues for examination under a microscope. When only a sample of tissue is removed, the procedure is called an incisional biopsy or core biopsy. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When a sample of tissue or fluid is removed with a needle, the procedure is called a needle biopsy or fine-needle aspiration.
Gleason Score (GS) - Gleason Grade: A system of grading prostate cancer cells based on how they look under a microscope. Gleason scores range from 2 to 10 and indicate how likely it is that a tumor will spread. A low Gleason score means the cancer cells are similar to normal prostate cells and are less likely to spread; a high Gleason score means the cancer cells are very different from normal and are more likely to spread.
A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions.
A doctor who identifies diseases by studying cells and tissues under a microscope.
The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer.
A mass of excess tissue that results from abnormal cell division. Tumors perform no useful body function. They may be benign (not cancerous) or malignant (cancerous).
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