A Regional Prostate Cancer diagnosis, also known as Non-Metastatic Prostate Cancer or Stage 4A Prostate Cancer, means that the cancer has spread to the closest lymph nodes in your pelvis shown at the top of the image in green.  It has not spread to any other organs in your body.

What Tests Will I Need and Why?

Blood and Imaging tests are done to understand your general health, confirm your diagnosis and determine your cancer stage.

Tissue Analysis is done to identify the prostate cancer cell type and the Gleason Score, which is critical to finding the best treatment option for you.

At Stage 4A, your PSA can be found at any level and your Gleason Score can range from 2-10, Grade Group 1-5.

You may also require special Saliva or Blood Analysis to look for specific mutations, actual changes in your body’s DNA, called BRCA1 and BRCA2.

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A Prostate Cancer diagnosis is based upon the results of staging and two tests called the Gleason Score and the prostate-specific antigen (PSA) tests

Finding Your Gleason Score

Samples of your cancer cells are examined to find out your Gleason Score.  A Gleason Score, which will range between 2 and 10, describes how aggressive a prostate tumor is by looking at how similar or different the cancer cells look to healthy cells.

The Gleason Score is made up of 2 grades that range from 1 to 5. A low grade of 1 means that the cells in the tumor look very much like healthy prostate cells. Cells that look completely different to normal cells are assigned a higher score, usually 4 or 5.

• The first grade is given to describe the cells in the largest area of the tumor
• The second grade is given to describe the cells in the second largest area of the tumor.

When these two grades are added together, they give us a Gleason Score between 2 and 10. For example, 3+4 = Gleason Score 7.

 Prostate-Specific Antigen (PSA) tests

Your Dr. also measures PSA Density to help determine the aggressiveness of the prostate cancer found.  PSA Density is your PSA level, divided by the volume of the prostate gland.

A high PSA density is often a predictor of Prostate Cancer but please discuss your specific situation with your doctors.

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