Assessing the severity and spread of prostate cancer
The severity of the disease is mainly based on three factors - the grade of the cancer cells, the stage of the cancer, and the blood PSA level.
Grade of the cancer
The biopsy samples are looked at under the microscope to asses the cancer cells. By looking at certain features of the cells the cancer can be 'graded'. The common grading system used is called the Gleason Score.
- A Gleason score of 2, 3 or 4 is a low grade. The cells look reasonably similar to normal prostate cells. The cancer cells are said to be 'well differentiated'. The cancer cells tend grow and multiply quite slowly and are not so 'agressive'.
- A Gleason score of 5, 6 or 7 is an intermediate grade.
- A Gleason score of 8, 9 or 10 is a high grade. The cells look very abnormal and are said to be 'poorly differentiated'. The cancer cells tend to grow and multiply quite quickly and are more 'aggressive'.
Staging
If you are confirmed to have prostate cancer, further tests may be done to assess if it has spread. These tests are not advised in all cases. It depends on factors such as your age and the grade of the tumour cells. Tests which may be done include a bone scan, a CT scan, an MRI scan, an abdominal ultrasound scan, or other tests. (There are separate leaflets which describe each of these tests in more detail.) This assessment is called 'staging' of the cancer. The aim of staging is to find out:
- How much the tumour has grown, and whether it has grown through the wall of the prostate and into nearby structures such as the bladder wall.
- Whether the cancer has spread to local lymph nodes.
- Whether the cancer has spread to other areas of the body (metastasised).
The PSA level
As a general rule, the higher the PSA level in the blood, the greater the number of prostate cancer cells. The PSA level can give a good idea of how quickly the cancer is growing in the prostate or spreading to other parts of the body.
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ANN HOWARD, over 2 years
can anyone tell me what is the average number of the PSA test
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Ben Millward, about 1 year
I too would like to know a danger reading of the PSA test. I was diagnosed with cancer at a reading of 12 which rapidly went to 17 before my prostate was removed with surgery. Now my reading has gone from 0.02 to 0.2 in 6 months, which the surgeon calls insignificant. A 10 times increase is scary for me. what is an average reading?
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