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Types and grades of prostate cancer

The type of prostate cancer you have tells you about the type of cell that the cancer started in. The grade of a cancer tells you how much the cancer cells look like normal cells.

Knowing this helps your doctor decide which treatment you need.

Types of prostate cancer

Acinar adenocarcinoma

Adenocarcinomas are cancers that develop in the gland cells that line the prostate gland. They are the most common type of prostate cancer. Nearly everyone with prostate cancer has this type.  

Ductal adenocarcinoma

Ductal adenocarcinoma starts in the cells that line the ducts (tubes) of the prostate gland. It tends to grow and spread more quickly than acinar adenocarcinoma.

Transitional cell (or urothelial) cancer

Transitional cell cancer of the prostate starts in the cells that line the tube carrying urine to the outside of the body (the urethra). This type of cancer usually starts in the bladder and spreads into the prostate. But rarely it can start in the prostate and may spread into the bladder entrance and nearby tissues.

Squamous cell cancer

These cancers develop from flat cells that cover the prostate. They tend to grow and spread more quickly than adenocarcinoma of the prostate.

Small cell prostate cancer

Small cell prostate cancer is made up of small round cells. It’s a type of neuroendocrine cancer.

Other rare cancers

Other rare cancers can develop in the prostate, these include:

Grades of prostate cancer

The grade of a cancer tells you how much the cancer cells look like normal cells.

The grade gives your doctor an idea of how the cancer might behave and what treatment you need.

Doctors use the Gleason system to grade prostate cancer. They look at several samples of cells (biopsies) from your prostate.

A pathologist  grades each sample of prostate cells from 1 to 5.

  • Grade 1 and 2 are thought of as normal prostate cells.
  • Grade 3 to 5 are cancer cells, with grade 5 being the most abnormal.

The pathologist works out an overall Gleason score by adding together the 2 most common Gleason grades.

So for example, if the most common grade is grade 3, and the second most common is grade 4, then the overall Gleason score is 7. Or they might write the scores separately as 3 + 4 = 7.

Last reviewed: 
31 May 2019
  • AJCC Cancer Staging Manual (7th Edition)
    American Joint Committee on Cancer, 2010

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2014

  • Cancer principles and practice of oncology (10th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Wolters Kluwer Health, 2015

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