Stage and Grade

The current Gleason grading system recognises three patterns or grades of cancer. These are given a number 3 to 5. However, the pattern of any one cancer can be mixed and the prognosis for any patient depends upon this mixed pattern. The two most common patterns are each given a separate number and then the two numbers are added to give the Gleason grade, for example 3+4=7. The Gleason grade can therefore be between 6 and 10.

A Gleason grade or score 3+3=6 tumour has a relatively good prognosis and is often just monitored, a Gleason 7 tumour is intermediate and a Gleason 8 to 10 has a poor prognosis. In the Gleason 7 category a Gleason 4+3=7 tumour is a worse tumour than a Gleason 3+4=7 as there is more Gleason 4 pattern than 3 pattern.

As well as the pattern of the growth or tumour, the extent of the cancer felt on digital rectal examination (DRE) is also important in estimating a prognosis. The extent of cancer is referred to as the stage. Stage 1 (T1) cancers cannot be felt on DRE, stage 2 (T2) cancers can be felt, but still feel to be within the prostate, stage 3 (T3) are felt to have extended outside the prostate and stage 4 (T4) are felt to be well outside the prostate, invading adjacent organs such as the bladder or pelvic wall.

Click here for the video, 'Prostate cancer and staging'.


Key aspects

From diagnosis and treatment to rehabilitation and research, I believe my highly experienced team and I bring a multifaceted approach to understanding and helping our patients. A summary of these key aspects of that approach is available here in PDF format. If you are suffering from prostate cancer or have reason to believe you might be, you are welcome to contact us or, intially, complete our comprehensive second opinion form.