There are four categories that describe the prostate tumor’s (T) stage, ranging from T1 to T4, or Stage A to D, indicated as follows:
Grade 1 – Small, uniform cells, tightly packed
Grade 2 – Varied cell sizes and shapes, loosely packed
Grade 3 – Increased cell size and shape irregularity, less distinction between cells
Grade 4 – Large, irregular fused cells
Grade 5 – Irregular, fused cells that have invaded surrounding connective tissue cells
Biopsy – small samples of tissue are taken from the prostate and the tissue is evaluated by a pathologist who assigns a Combined Gleason Grade Score (CGS) ranging from 2 through 10. The higher the number, the more aggressive the cancer.
Prostatic Acid Phosphatase (PAP) blood test – determines if the cancer has spread beyond or is confined to the prostate.
Computed tomography (CT) scan – produces detailed cross-sectional images of the body using hundreds of X-ray like images to determine if the prostate cancer has spread into other organs. While CT scans are ideal for determining skeletal structures, they have a limited mass size resolution.
Magnetic resonance imaging (MRI) – uses strong magnetic fields to produce an image of the body based on cellular oscillation emitted energy. MRI scans produce a very clear picture of the prostate gland and can show whether the cancer has spread beyond it.
Endorectal MRI – helpful in determining if the cancer is confined to the gland and detecting the site of the cancer in men whose prostate cancer cannot be diagnosed with other routine tests.
Radionuclide bone scan – can determine whether cancer has spread from the prostate to the bones. It is common for prostate cancer to spread first to skeletal structures before other organs in the body.
ProstaScint scan – detects the spread of prostate cancer to lymph nodes and other soft (non-bone) organs. It can distinguish from other cancers and benign disorders; however, its sensitivity and specificity are relatively low.
Lymph node sampling – another way of finding if the cancer has spread to nearby lymph nodes and is typically performed when there is a high suspicion of spreading.