After your TRUS or template biopsy, the samples of tissue will be looked at under a microscope to check for any cancer cells. Your doctor will be sent a report, called a pathology report, with the results. The results will show whether any cancer was found. They may also show how many biopsy samples contained cancer and how much cancer was present in each sample.
You might be sent a copy of the pathology report. And you can ask to see copies of letters between the hospital and your GP. If you have trouble understanding any of the information, ask your doctor to explain it or speak to our Specialist Nurses.
I asked to see the letters from the hospital to my GP. It helped me remember the different tests and discussions that I’d had.
- A personal experience
If cancer is found
If cancer is found, this is likely to be a big shock, and you might not remember everything your doctor or nurse tells you. It can help to take a family member, partner or friend with you for support when you get the results. You could also ask them to make some notes during the appointment.
How likely is my prostate cancer to spread?
Your biopsy results will show how aggressive the cancer is – in other words, how likely it is to spread outside the prostate. You might hear this called your Gleason grade, Gleason score, or grade group.
Gleason grade
When cells are seen under the microscope, they have different patterns, depending on how quickly they’re likely to grow. The pattern is given a grade from 1 to 5 – this is called the Gleason grade. Grades 1 and 2 are not cancer, and grades 3, 4 and 5 are cancer. If you have cancer, the higher the grade, the more likely the cancer is to spread outside the prostate.
Gleason score
There may be more than one grade of cancer in the biopsy samples. An overall Gleason score is worked out by adding together two Gleason grades.
The first is the most common grade in all the samples. The second is the highest grade of what’s left. When these two grades are added together, the total is called the Gleason score.
Gleason score = the most common grade + the highest other grade in the samples
For example, if the biopsy samples show that:
- most of the cancer seen is grade 3, and
- the highest grade of any other cancer seen is grade 4, then
- the Gleason score will be 7 (3+4).
If you have prostate cancer, your Gleason score will be between 6 (3+3) and 10 (5+5).
Grade group
Your doctor might also talk about your "grade group". This is a new system for showing how aggressive your prostate cancer is likely to be. Your grade group will be a number between 1 and 5 (see table).
What does the Gleason score or grade group mean?
The higher your Gleason score or grade group, the more aggressive the cancer and the more likely it is to grow and spread outside the prostate. We've explained the different Gleason scores and grade groups that can be given after a prostate biopsy below. This is just a guide. Your doctor or nurse will talk you through what your results mean.
Gleason score 6 (3 + 3) All of the cancer cells found in the biopsy look likely to grow slowly (grade group 1).
Gleason score 7 (3 + 4) Most of the cancer cells found in the biopsy look likely to grow slowly. There are some cancer cells that look likely to grow at a moderate rate (grade group 2).
Gleason score 7 (4 + 3) Most of the cancer cells found in the biopsy look likely to grow at a moderate rate. There are some cancer cells that look likely to grow slowly (grade group 3).
Gleason score 8 (3 + 5) Most of the cancer cells found in the biopsy look likely to grow slowly. There are some cancer cells that look likely to grow quickly (grade group 4).
Gleason score 8 (4 + 4) All of the cancer cells found in the biopsy look likely to grow at a moderate rate (grade group 4).
Gleason score 8 (5 + 3) Most of the cancer cells found in the biopsy look likely to grow quickly. There are some cancer cells that look likely to grow slowly (grade group 4).
Gleason score 9 (4 + 5) Most of the cancer cells found in the biopsy look likely to grow at a moderate rate. There are some cancer cells that are likely to grow quickly (grade group 5).
Gleason score 9 (5 + 4) Most of the cancer cells found in the biopsy look likely to grow quickly. There are some cancer cells that looklikely to grow at a moderate rate (grade group 5).
Gleason score 10 (5 + 5) All of the cancer cells found in the biopsy look likely to grow quickly (grade group 5).
What type of prostate cancer do I have?
Your doctor will look at your biopsy results to see what type of prostate cancer you have.
For most men who are diagnosed, the type of prostate cancer is called adenocarcinoma or acinar adenocarcinoma – you might see this written on your biopsy report. There are other types of prostate cancer that are very rare. Read more about rare prostate cancers.
If no cancer is found
If no cancer is found this is likely to be reassuring. However, this means ‘no cancer has been found’ rather than ‘there is no cancer’. Sometimes, there could be some cancer that was missed by the biopsy needle.
What else might the biopsy results show?
Sometimes a biopsy may find other changes to your prostate cells, called prostate intraepithelial neoplasia (PIN) or atypical small acinar proliferation (ASAP). Read more about PIN and ASAP.
