Based on the biopsy, the pathologist will assign a Gleason score between 2 and 10 based on the degree of similarity between normal prostate tissue and the patient’s biopsy sample. Scores closest to 2 are still very similar to normal prostate tissue, while those closer to 10 indicate that a cancer is more likely to spread.
Some men may also undergo additional tests to determine if and where the cancer has spread.
- A radionucleotide bone scan can help determine if the cancer has spread to the bones.
- A computed tomography (CT or CAT) scan can show if the cancer has spread beyond the prostate to the lymph nodes or other organs in the pelvis.
- A magnetic resonance imaging (MRI) scan produces a clear picture of the prostate, indicating the extent of spread within and outside of the organ.
- A lymph node biopsy provides doctors with a sample of lymphatic tissue, which can be tested for the presence of cancer. The sample may be obtained surgically, laproscopically or using a technique called fine needle aspiration.