Staging and Grading
Once the diagnosis of prostate cancer has
been made the disease has to be staged and
graded. The stage refers to the extent and
spread of the disease while the grade refers
to the nature (aggressiveness) of the
particular tumor. Staging will determine the
extent of disease and provide important
prognostic information that will influence
the management decisions.
Staging investigations - PSA - X-rays of
lumbar spine and pelvis - Chest X-ray -
Radionuclitide bone scan - MTI scan of pelvis
TNM Staging system
T stage (extent of primary lesion)
- T1 - tumor confined to prostate, not
palpable or visible on TRUS - T2 - tumor
palpable or visible on TRUS but confined to
prostate - T3 - spread beyond the prostatic
capsule - T3a - extracapsular spread only -
T3b - involvement of the seminal vesicles -
T4 - invasion into rectal wall, bladder neck
or pelvic wall N (Nodal) status - N0 -
regional nodes not involved - N1 - regional
nodes involved by tumor M (Distant
Metastases) - M0 - no distant metastases -
M1 - distant metastases present
Grading
Grading refers to what the cancer looks like
under a microscope. The most commonly used
system is the Gleason grade and score. The
glandular pattern is compared to that of a
normal prostate and scored out of 5, where 1
resembles a pattern very close to normal and
5 resembles severely distorted glandular
architecture. The two predominant glandular
patterns within the cancer are graded out of
5 and the combined score calculated out of
10. The higher the Gleason score, the more
aggressive is the tumor and the worse is the
prognosis. Patients with cancers confined to
the prostate (T1 and T2) and no involvement
of the lymph nodes or other organs (N0 and
M0) are potentially curable by surgery or
radiotherapy. Patients with disease beyond
the prostate are not curable.
With our next information – we will inform
you about the "Risk factors for enlarged
prostate" – so you should have a look on
this site in the next 2 weeks! If you have
any question sends us your e-mail.
Health-Service-Online Fritz Frei Admin
http://www.cancer-info.info
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