NCCN Guidelines for Patients® | Prostate Cancer - page 13

13
NCCN Guidelines for Patients
®
: Prostate Cancer
Version 1.2014
Part 2: Cancer staging
Par t 1
Par t 2
Par t 3
Par t 4
Par t 5
Par t 6
Par t 7
Par t 8
Par t 9
Definitions:
Epididymis:
The tube
through which sperm travel
after leaving the testicles
Primary tumor:
The first
mass of cancer cells in the
body
Side effect:
An unhealthy
or unpleasant physical or
emotional response to a test
or treatment
most prostate cancers are scored 6 to 10. Higher Gleason scores mean the
cancer is more likely to grow and spread.
The Gleason score is the sum of two grades. Figure 3 depicts the grades of
prostate cancer. Glands comprised of cells with a grade of 1 or 2 can’t be scored
on a prostate biopsy. Therefore, Gleason grades range from 3 for glands made of
cancer cells that look almost normal to 5 for very abnormal cells that aren’t able
to form glands. The primary grade is the most common Gleason pattern, and the
secondary grade is the second most common Gleason pattern. The primary and
secondary grades are added together to give the Gleason score. Gleason scores
of 6 are associated with favorable prostate cancer; scores of 7 are associated
with intermediate prostate cancer; and scores of 8 to 10 are assoicated with
aggressive prostate cancer.
2.5 TNM scores
The AJCC (
A
merican
J
oint
C
ommittee on
C
ancer) staging system is used to
stage prostate cancer. In this system, the letters T, N, and M describe a different
location of cancer growth. Your doctors will assign a score to each letter. These
scores will be combined to assign the cancer a TNM stage.
T = Tumor
The T score is a rating of the size and extent of the primary tumor. T1 tumors
can’t be felt or seen with imaging tests. They are found in tissue removed by
biopsies or surgical treatment. For example, prostate cancer may be found
in men who had an abnormal PSA level or who had an operation for urinary
problems caused by an enlarged prostate. Prostate cancer discovered as a result
of an operation for voiding problems is called an incidental finding.
T1a
means that incidental cancer was found in 5% or less of the removed
tissue.
T1b
means that incidental cancer was found in more than 5% of the
removed tissue.
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