Diagnosis

Biopsy

• This is conducted following abnormal DRE or PSA test, to confirm diagnosis and help stage prostate cancer if it is present.¹
• An ultrasound probe (transrectal ultrasound, or TRUS) is passed into the rectum. This helps guide the biopsy needle. Six to 12 samples of tissue are taken from different parts of the prostate.¹

Potential adverse effects¹

• Rectal bleeding.
• Haematuria.
• Hermatospermia.
• Urinary retention.
• Infection.
• Pain.

References

1. The Cancer Council NSW. Fact Sheet – Prostate Cancer, July 2004. Online. Viewed 3/12/04. Available at http://www.cancercouncil.com.au/editorial.asp?pageid=1121

Grading

The Gleason Grading System¹

• Categorises the degree of dedifferentiation of cells as a marker of the aggressiveness of the cancer.
  • Grade 1 tumours consist of small uniform glands which are almost normal.
  • Grade 2 tumours, though slightly larger glands, are still separated but more closely arranged.
  • Grade 3 tumours (the most common grade of cancer) show marked variation in gland size and organisation. The tumour infiltrates or invades the adjacent prostate tissue.
  • Grade 4 tumours show fusion or joining of the glands and the glands are much less defined.
  • Grade 5 tumours are characterised by solid sheets or cords of tumour with no attempt to form glands.

Prostate cancer scores¹

References

1. Gleason DF. The Veterans Administration Co-operative Urologic Research Group. Histologic staging and grading of prostatic carcinoma, 1977.