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Grade describes how closely the tumor resembles normal prostate tissue. Based on the microscopic appearance of tumor tissue, pathologists may describe it as low-, medium-, or high-grade cancer. One way of grading prostate cancer, called the Gleason system, uses a Gleason score of 2 to 10. Another system uses levels G1 through G4. In both systems, the higher the score, the higher the grade of the tumor. High-grade tumors generally grow more quickly and are more likely to spread than low-grade tumors.
The grade offers a good clue to your tumor's behavior: A tumor with a low grade is likely to be slow-growing, while one with a high grade is more likely to grow aggressively or to have already spread outside the prostate (metastasized).
Stage refers to the extent of the prostate cancer. Early prostate cancer, stages I and II, is localized. It has not spread outside the gland. Stage III prostate cancer, often called locally advanced disease, extends outside the gland to the seminal vesicles. Stage IV means that the cancer has spread to lymph nodes and/or to other tissues or organs.
In 1990, two-thirds of newly diagnosed prostate cancers were stage I or II (clinically localized). Slightly more than 10 percent were stage III (regional), while about 20 percent were stage IV (metastatic).
(Click Stages of Prostate Cancer to read more about how stage is used to diagnose the disease.)
Once you receive your doctor's opinion about what prostate cancer treatment you need, it may be helpful to get more advice before you make up your mind. Other doctors' opinions can help you make one of the most important decisions of your life. Getting another doctor's advice is normal medical practice, and your doctor can help you with this effort. Many health insurance companies require and will pay for other opinions. Another opinion can help you:
- Confirm or adjust your treatment plan based on the diagnosis and stage of the disease
- Get answers to your questions and concerns, and help you become comfortable with your decisions
- Decide about taking part in clinical trials of new prostate cancer treatment methods.
You may also consider contacting a prostate cancer support group in your area. Talking with other men who have experienced the various procedures available may help you to understand better the treatment options described by your doctor.