Understanding your prostate cancer
Watch our animation about understanding your prostate cancer:
What do my test results mean?
Your doctor will look at your test results to find out if the cancer has spread (its stage) and how quickly it might be growing.
How far has my cancer spread?
The stage of your cancer tells you whether it has spread outside the prostate and how far it has spread. You might need scans, such as an MRI, CT or bone scan, to find out the stage of your cancer.
Depending on the results, your cancer may be treated as:
- localised prostate cancer – it's contained inside the prostate
- locally advanced prostate cancer – it’s started to break out of the prostate or has spread to the area just outside it
- advanced prostate cancer – it’s spread from the prostate to other parts of the body.
Cambridge Prognostic Group (CPG)
If you have localised or locally advanced prostate cancer, your doctor may talk to you about the risk of your cancer spreading outside the prostate. To work out your risk, your doctor will look at your PSA level, your Gleason score and the T stage of your cancer.
These three factors will place you in one of five categories that form the Cambridge Prognostic Group (CPG). This system is used to help your doctor decide which treatment options are suitable to you, based on your risk.
The five CPG categories are described below. If you have any questions about your CPG speak to your doctor or specialist nurse.
- Gleason score 6 (grade group 1), and
- PSA less than 10 ng/ml, and
- T stage of 1 or 2.
This means your cancer is likely to grow very slowly and very unlikely to spread. Your treatment options may include active surveillance, surgery and radiotherapy.
You will be in this group if you have a T stage of 1 or 2 and one of the following:
- Gleason score is 3 + 4 = 7 (grade group 2), or
- PSA 10 to 20 ng/ml.
This means your cancer is likely to grow slowly and unlikely to spread. Your treatment options may include active surveillance, surgery and radiotherapy with hormone therapy.
- Gleason score 3 + 4 = 7 (grade group 2), and
- PSA 10 to 20 ng/ml, and
- T stage of 1 or 2.
You will also be in this group if you have:
- Gleason 4 + 3 = 7 (grade group 3), and
- T stage of 1 or 2.
This means there is a medium (intermediate) risk of your cancer growing and spreading out of your prostate. Your treatment options may include surgery or radiotherapy with hormone therapy.
You may also have active surveillance if you don’t want treatment straight away or can’t have treatment.
You will be in this group if you have only one of the following:
- Gleason score 8 (grade group 4), or
- PSA more than 20 ng/ml, or
- T stage 3.
This means that there is a high risk of your cancer growing quickly and spreading out of your prostate. Treatment options may include surgery and radiotherapy with hormone therapy.
You will be in this group if you have two or more of the following:
- Gleason score 8 (grade group 4), and
- PSA more than 20 ng/ml, and
- T stage 3.
You will also be in this group if you have one of the following:
- Gleason score 9 to 10 (grade group 5), or
- T stage 4.
This means that there is a high risk of your cancer growing quickly and it’s very likely to spread. Treatment options may include surgery or radiotherapy with hormone therapy.
Low, medium or high risk prostate cancer
When talking to your doctor about the risk of your cancer spreading, they may refer to low, medium or high risk. This older system also used your PSA level, Gleason score and the T stage of your cancer. You should ask your doctor about your CPG category and what this means in terms of your treatment options.
What happens next?
The results should help you and your doctor decide which treatments might be suitable for you. Ask your doctor or nurse to explain your test results if you don’t understand them. Or you could call our Specialist Nurses.
If you’re concerned that your doctor is using the old system, rather than the CPG system, please talk to them about it. The information on this page can help to inform them of the new system. It's important to remember that both systems are only intended as guides for your doctor, and they will consider many other clinical factors when advising you about your treatment options.
Dealing with prostate cancer
Being diagnosed and living with prostate cancer can change how you feel about life. If you or your loved one is dealing with prostate cancer you may feel scared, stressed or even angry. There is no ‘right’ way to feel and everyone reacts differently.
Visit our wellbeing hub for information to help support you in looking after your emotional, mental, and physical wellbeing. If you are close to someone with prostate cancer, find out more about how you can support someone with prostate cancer and where to get more information.
Updated: May 2022｜To be reviewed: September 2022
- Manit Arya, Consultant Urological Surgeon, University College Hospital, London
- Zoe Storton, Uro-oncology Clinical Nurse Specialist, Bradford Teaching Hospitals NHS Foundation Trust
- Alastair Thomson, Consultant Clinical Oncologist, Royal Cornwall Hospitals NHS Trust
- Karen Wilkinson, Uro-oncology Clinical Nurse Specialist, University College Hospital, London
- Our Specialist Nurses
- Our Volunteers.
Parry MG, Cowling TE, Sujenthiran A, Nossiter J, Berry B, Cathcart P, et al. Risk stratification for prostate cancer management: value of the Cambridge Prognostic Group classification for assessing treatment allocation. BMC Med. 2020 May 28;18(1):114.
National Institute for Clinical Excellence. Prostate Cancer: diagnosis and management. Full guideline NG131. 2021
Mottet N, Van den Bergh RCN, Briers E, Bourke L, Cornford P, De Santis M, et al. EAU - ESTRO - ESUR - SIOG Guidelines on Prostate Cancer. European Association of Urology; 2018.
- National Institute for Clinical Excellence. Prostate Cancer: diagnosis and treatment. Full guideline 175. 2014.