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Types and grades

Find out about number and TNM staging and the grades and types of prostate cancer.

Stages of cancer

The stage of a cancer tells you how big it is and how far it’s spread. It helps your doctor decide which treatment you need.

The tests and scans you have to diagnose your cancer give some information about the stage. Sometimes it’s not possible to be certain about the stage of a cancer until after surgery.

Doctors can use a number system or the TNM system to stage your cancer. 

Types of prostate cancer

The type of prostate cancer you have tells you the type of cell that the cancer started in. Knowing this helps your doctor decide which treatment you need.

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: 
05 Jul 2016
  • AJCC Cancer Staging Manual (7th Edition)

    S Edge (and others). Springer. 2011

  • Cancer and its management (7th edition)

    J Tobias and D Hochhauser DWiley-Blackwell, 2014

  • Cancer: Principles and practice of oncology (9th edition)

    DeVita VT, Lawrence TS and Rosenberg SA Lippincott, Williams and Wilkins, 2011

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