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Understanding prostate cancer clinical characteristics

An Elderly Gentleman in His Doctors Office Receiving a Check-Up

Characteristics of prostate tumors play an important role in deriving the stage and risk group of your cancer. By understanding the characteristics, you can better understand the nature and aggressiveness of your prostate cancer. The three clinical characteristics include prostate-specific antigen (PSA), Gleason score, and tumor grade which are determined by blood tests and prostate biopsy.

PSA (Prostate-Specific Antigen) 

PSA, or prostate-specific antigen, is a protein the prostate gland produces. PSA levels can be measured through a blood test and are often used as a screening tool for prostate cancer. 

While elevated PSA levels can indicate the presence of prostate cancer, it’s important to note that PSA levels can also be affected by other factors such as age, prostate size, and inflammation. A high PSA level may prompt further evaluation, including a digital rectal exam (DRE) and possibly a prostate biopsy, to determine the cause of the elevation and whether prostate cancer is present. 

Discussing your PSA levels with your healthcare provider is essential to understanding the implications and determining the most appropriate course of action. 

Gleason Score and Pattern 

The Gleason score is a grading system used to evaluate the aggressiveness of prostate cancer based on the appearance of cancer cells under a microscope. The Gleason score ranges from 6 to 10 and is assigned by a pathologist based on the two largest areas of cancer cells in the biopsy sample. 

The primary pattern, representing the largest area of the tumor, is assigned a grade from 1 to 5 based on how closely it resembles normal, healthy prostate tissue (1 is most like normal prostate tissue; 5 is least like normal prostate tissue). The secondary pattern, representing a smaller proportion of the tumor, is also assigned a grade. 

The two grades are then added together to calculate your Gleason score. The Gleason pattern reflects the contribution of the primary and secondary scores to the Gleason score. For example, if the primary score is 3 and the secondary score is 5, the Gleason pattern is 3+5. A higher Gleason score indicates a more aggressive cancer with a higher likelihood of growing and spreading beyond the prostate gland. 

Tumor Grade

The tumor grade is derived from the Gleason score and Gleason pattern and refers to the degree of abnormality and aggressiveness of prostate cancer cells. Tumor grade can range from 1 to 5, with a higher score indicating more abnormal and aggressive cancer cells. The tumor grade is one of the clinical characteristics used to determine cancer stage and risk group. 

Your PSA, Gleason score, and tumor grade help determine what treatments you need, so understanding the role of these three characteristics is essential to feeling empowered on your prostate cancer diagnosis. 

If you have questions, you can connect with an Outcomes4Me oncology nurse practitioner at no charge through the Outcomes4Me app, using the Ask Outcomes4Me button.

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