Cancer Staging, Gleason Scores & PSA

Understanding Cancer Staging, Gleason Scores & PSA

Understanding Cancer Staging, Gleason Scores & PSA

Prognostic Tools1-4

You have metastatic (advanced) prostate cancer – but what does this mean for your health? Doctors use different staging tools to help define this.

"Will I survive, doctor?" is a question many ask their doctors when given the news of cancer. While no definitive answers can be given, your doctor can try and provide you with a prognosis – that is, an estimate of how your cancer will affect you and if it will respond to treatment.1

Getting to the picture of a prognosis depends on several pieces of information, including:2

Your Medical History
Your Type of Cancer
Characteristics of the cancer
Treatments Used & How You Responded
Want to talk to your doctor about your prostate cancer, but don’t know where to start? Take a look at some helpful "Start the Conversation" question sheets here.

Staging: An important prognostic factor

Knowing what stage your cancer is in will help determine your prognosis:





Cancer confined to prostate

Cancer spread outside prostate

Cancers confined to the prostate (T1 and T2) have a better prognosis than those spread outside the prostate (T3 and T4).

The Gleason Score:

Understanding the aggressiveness of a tumour

The Gleason Score is the most common measure used in prostate cancer. This classification system grades tumours on how aggressive they may be and how likely they are to spread. To assess one’s Gleason Score, a sample of tumour cells is examined under a microscope.




More Favourable Prognosis

Intermediate Prognosis

Less Favourable Prognosis

PSA Levels:

The prostate-specific antigen (PSA) is a protein that circulates in the bloodstream. A blood test is used to measure your PSA level.

<10 ng/mL

Between 10-20 ng/mL

>20 ng/mL

More Favourable Prognosis

Intermediate Prognosis

Less Favourable Prognosis

Additional Factors to Look at…

In addition to the tools described above, your doctor will examine other factors that can play a role in your overall prognosis:

  • Is your prostate cancer hormone-resistant? Despite taking away the "fuel" of androgen that feeds cancer, some cancers continue to grow. This is called "hormone resistant" or "castrate resistant" prostate cancer.4

Like a puzzle, learning about your prostate cancer involves different pieces of information. From staging to tumour scores to your physical health, there are so many factors for your healthcare team to consider. Understanding your unique situation will help your healthcare team figure out what treatment options may work best for you.


  1. Canadian Cancer Society. Prognosis and survival for prostate cancer. Online. Available at:
  2. Canadian Cancer Society. Gleason classification for prostate cancer. Online. Available at:
  3. Prostate Cancer UK. PSA Test. Online. Available at:
  4. Urology Care Foundation. Advanced Prostate Cancer. Online. Available at:
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