Prostate cancers are graded on how closely the cells in the sample resemble normal cells. Cells that look very different from the normal ones in the prostate could well indicate a cancer that grows faster. The system most often used for grading is the Gleason system. Using this system, samples from two areas of the prostate are graded from 1 to 5. The numbers are graded to give a score of between 2 and 10. The lower this number is, the more the cells in the sample resemble normal prostate cells. A higher score means the cancer is likely to grow more quickly. The patient should ask their doctor to explain the tumor grade.

Tests to determine a man’s stage for prostate cancer include:

• Magnetic Resonance Imaging (MRI). This test utilizes a computer, radio waves, and a magnet to produce a series of detailed pictures of areas inside the body.
• CT (CAT) Scan. Detailed pictures are taken from different angles of areas in the body. They are generated by an x-ray machine linked to a computer. The healthcare professional may inject a dye into a vein, or the patient may swallow it, to help obtain more clear pictures of the organs or tissues.
• Radionuclide Bone Scan. This procedure is performed to determine whether or not there are rapidly dividing cells such as those with cancer in the bones. A tiny amount of radioactive material is injected into a vein. The material moves through the bloodstream and is collected in the bones. Then it is detected by a scanner.
• Pelvic Lymphadenectomy. Lymph nodes are removed from the pelvis. The tissue is searched for cancer cells.
• Seminal Vesicle Biopsy. This involves removing fluid from the seminal vesicles (glands that produce the semen) by using a needle. The fluid is viewed under a microscope to discover any cancer that may be there.

These test results, along with those of the tumor biopsy, are viewed together in order for the pathologist to determine the accurate prostate cancer stage.

Prostate Cancer Stages
Following are the stages used for prostate cancer:

• Stage I (or A). At this beginning stage, cancer cells are discovered only in the prostate gland. This stage is usually found accidentally during surgery for other reasons. It cannot be determined using a DRE and is not visible by imaging.
• Stage II (or B). While this stage is more advanced that that of Stage I, the cancer has not spread beyond the prostate.
• Stage III (or C). Here, the cancer has spread to nearby tissues. It may also be found in the seminal vesicles.
• Stage IV (or D). In this later stage, the cancer has metastasized, or spread, to lymph nodes either near or far from the prostate or to other parts of the body such as the lungs, liver, bladder, or rectum. Also, metastatic prostate cancer may often spread to the bones.