Staging Tests

The staging of a prostate cancer must take into account several different factors including the results of the digital rectal exam, the PSA test and the biopsy.

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.
  • 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.
  • magnetic resonance imaging (MRI) scan produces a clear picture of the prostate, indicating the extent of spread within and outside of the organ.
  • 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.