Grading

Determining the grade of prostate cancer involves examining a tissue sample of the prostate tumour cells under a microscope. By examining how similar or different the cancer cells are compared to your normal prostate cells, your doctor will be able to determine if you have a high- or low-grade cancer. The two systems for grading cancers are 1) General Grading System and 2) Gleason Grading System.
 
1) General Grading System

This grading system classifies prostate cancer cells as low-, intermediate- or high-grade based on the appearance of the cancer cells as compared to healthy prostate cells.
 
Low-grade    This type of cancer cell is slow-growing and looks similar to normal prostate cells
Intermediate-grade        This type of cancer cell is more aggressive than low-grade tumour cells and looks abnormal as compared to low-grade cells.
High-grade This type of cancer cells is extremely aggressive and grows and spreads quickly. They do not resemble healthy prostate cells at all.
 
2) Gleason Grading System

The Gleason grading system is a measure from 2 to 10 that allows your doctor to determine how aggressive your cancer is. An aggressive cancer is more likely to spread to other parts of your body. A higher number indicates a more aggressive cancer. The Gleason score is the best predictor of the progression and growth of your cancer.
 
Gleason Grade:

To determine your overall Gleason score, the pathologist must first determine the Gleason grade. The Gleason score is the sum of the primary and secondary grade, each is given a score from 1 to 5. 
 
To determine the primary Gleason grade, the pathologist looks at the most common tumor pattern and from there looks at what grade the cancerous cells in this pattern are. The bigger the difference in appearances between the healthy and cancerous cells the higher the Gleason grade (up to 5). 
 
The secondary Gleason grade is determined the same way however, the pathologist looks at the second most common tumor pattern. 
 

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