Grading refers to what the cancer looks like under a microscope. The most commonly used system is the Gleason grade and score. The glandular pattern is compared to that of a normal prostate and scored out of 5, where 1 resembles a pattern very close to normal and 5 resembles severely distorted glandular architecture. The two predominant glandular patterns within the cancer are graded out of 5 and the combined score calculated out of 10. The higher the Gleason score, the more aggressive is the tumour and the worse is the prognosis.
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Patients with cancers confined to the prostate (T1 and T2) and no involvement of the lymph nodes or other organs (N0 and M0) are potentially curable by surgery or radiotherapy. Patients with disease beyond the prostate are not curable.
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