Diagnostic Tests

To help make an accurate diagnosis your physician will utilize the following examinations:

Gleason Grading and Gleason Scores

Normal prostate cells, just like all other cells in the body, are constantly reproducing and dying, and each new prostate cell has the same shape and appearance as all of the other prostate cells. But cancer cells look different, and the degree to which they look different from normal cells is what determines the cancer grade. "Low-grade" tumor cells tend to look very similar to normal cells, whereas "high-grade" tumor cells have changed so much that they often barely resemble the normal cells.

The Gleason grading system accounts for the five distinct patterns that prostate tumor cells tend to go through as they change from normal cells. The scale runs from 1 to 5, where 1 represents cells that are very nearly normal, and 5 represents cells that don't look much like prostate cells at all.

After examining the cells under a microscope, the pathologist looking at the biopsy sample assigns one Gleason grade to the most common pattern in that sample, and a second Gleason grade to the next most common pattern. This is repeated for each of the samples taken from the prostate gland. The two grades are added, and the Gleason score, or sum, is determined for that sample.

Generally speaking, the Gleason score tends to predict the aggressiveness of the disease and how it will behave. The higher the Gleason score, the less the cells behave like normal cells, and the more aggressive the tumor tends to be.

If the biopsy shows cancer then other tests may be done to check if it has spread including.