It usually takes around two weeks to get all the results. These can give an indication of how far the cancer has spread and how quickly it might be growing.

  • If your PSA test shows that you have a high PSA level for your age, this could be a sign of prostate cancer, but it can also be caused by other things.
  • If your DRE shows that your prostate is larger than expected this could be a sign of an enlarged prostate. A prostate with hard, bumpy areas may suggest prostate cancer.
  • If your biopsy shows there is cancer present, the results are used to work out your Gleason score. This can give an idea of how likely the cancer is to spread.
  • The results of any scans you might have had will help to stage your cancer to show how far the cancer might have spread.

If you are diagnosed with prostate cancer, your doctor will look at your Gleason score from your biopsy results and the stage of your cancer from your DRE and any scans you might have had. You will then be diagnosed with either localised (early) prostate cancer, locally advanced prostate cancer or advanced prostate cancer.

 

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Localised prostate cancer

Localised prostate cancer is cancer that's contained inside the prostate. You may also hear it called early or organ-confined prostate cancer.

Prostate cancer can behave in different ways. Localised prostate cancer often grows slowly – or might not grow at all – and has a low risk of spreading. So it may never cause you any problems or affect how long you live. However, some cancers may grow more quickly and spread to other parts of the body.

The tests you have will help your doctor find out how your cancer is likely to behave, and what treatments might be suitable for you.

Is my cancer likely to spread?

Your doctor may talk about the risk of your cancer coming back after treatment. This will help you and your doctor to discuss the best treatments for you.

Low risk

  • your PSA level is less than 10ng/ml, and
  • your Gleason score is 6 or less, and
  • the stage of your cancer is T1 to T2a.

Medium risk

  • your PSA level is between 10 and 20ng/ml, or
  • your Gleason score is 7, or
  • the stage of your cancer is T2b.

High risk

  • your PSA level is higher than 20 ng/ml, or
  • your Gleason score is 8, 9 or 10, or
  • the stage of your cancer is T2c, T3 or T4.

Locally advanced prostate cancer

Locally advanced prostate cancer is cancer that has started to break out of the prostate, or has spread to the area just outside the prostate. It may have spread to the seminal vesicles, pelvic lymph nodes, neck of the bladder or back passage (rectum).

Different doctors may use the term 'locally advanced prostate cancer' to mean slightly different things, so ask your doctor or nurse to explain exactly what they mean.

Advanced prostate cancer

Advanced (metastatic) prostate cancer is cancer that has spread from the prostate to other parts of the body. It develops when prostate cancer cells move from the prostate to other parts of the body through the blood stream or lymphatic system.

Prostate cancer can spread to any part of the body, but most commonly to the bones and the lymph nodes.

Advanced prostate cancer can cause symptoms, such as fatigue (extreme tiredness), bone pain and problems urinating. The symptoms you have will depend on where the cancer has spread to. Some men with advanced prostate cancer only get a few symptoms.

What happens next?

Your test results will help your multi-disciplinary team (MDT) - the team of health professionals involved in your care - to find out how your cancer is likely to behave, and what treatments might be suitable for you.

If you're not sure whether your prostate cancer is localised, locally advanced or advanced, speak to your doctor or nurse. They can explain your test results and the treatment options available. Or you could call our Specialist Nurses for more information or support, or speak to a nurse online. You can also request a second opinion from another specialist by talking to your GP.

It can be hard to take everything in, especially when you've just been diagnosed. Make sure you have all the information you need, and give yourself time to think about what is right for you. Your doctor or nurse can help you think about the pros and cons.

It can help to write down any questions you want to ask at your next appointment. And to write down or record what’s said to help you remember it. It can also help to take someone to appointments, such as your partner, friend or family member. There is also support available.

Rare types of prostate cancer

As well as giving the Gleason score, a biopsy also looks at the type of cancer cells. For most men who are diagnosed, the type of prostate cancer is adenocarcinoma, or acinar adenocarcinoma. You might see this written on your pathology report. There are other types of prostate cancer, which are very rare. These include:

  • small cell prostate cancer (neuroendocrine prostate cancer)
  • large cell prostate cancer (neuroendocrine prostate cancer)
  • ductal prostate cancer (ductal adenocarcinoma)
  • mucinous prostate cancer (mucinous adenocarcinoma)
  • signet ring cell prostate cancer
  • basal cell prostate cancer (adenoid cystic prostate cancer)
  • prostate sarcomas, such as leiomyosarcoma.

If you are diagnosed with one of these rare kinds of prostate cancer, you can read more here. Speak to your doctor or nurse about what it means and about the treatments available to you.

Questions to ask your doctor or nurse

  • What is my PSA level?
  • Will I need a biopsy? What type of biopsy will I have?
  • What are the risks and side effects of having a biopsy?
  • What are my Gleason grades and Gleason score?
  • Will I need an MRI, CT or bone scan?
  • What is the stage of my cancer? What does this mean?
  • What treatments are suitable for me?