When your doctor diagnoses you with advanced prostate cancer, they'll use several tests to plan your treatment. A biopsy and a Gleason score can check for cancer and help see how fast-growing your cancer is.
Transrectal Ultrasound-Guided Biopsy
What it is: A biopsy is a small sample of tissue -- in this case, from your prostate. Your doctor will send it for testing in a lab to check for cancer and see how fast your cancer might grow.
What happens: The procedure takes about 10 minutes. You can get it done in your urologist's office. You will be awake for it. It typically isn't very painful.
In the most common type of biopsy, your doctor places an ultrasound probe that's about the width of a finger in your rectum. It gives off sound waves that bounce off your prostate and create a black and white image on a video screen. A newer method uses an MRI scan to biopsy the prostate.
With the picture of your prostate, your doctor inserts a thin, spring-loaded, hollow needle through the wall of your rectum into your prostate gland. As your doctor removes the needle, they take out a tiny bit of prostate tissue.
Because prostate cancer is rarely only in one area of the prostate, your doctor will take an average of 12 tissue samples from different parts of your prostate. They may take more samples of tissue if necessary.
It's possible to have different types of cancer in the same prostate. Your doctor will get each tissue sample checked by a lab. The lab report will tell your doctor if cancer is present in each sample, how much of the tissue sample contains cancer, and your Gleason score.
What it is: Your Gleason score isn't a separate test. It's a number based on the results of your biopsy.
It's the sum of two grades on your lab report. They focus on the most common and second-most common cancer cell patterns in your biopsy.
Gleason scores range from 2 to 10, and most prostate cancer will score 6 or higher. A higher score (8 to 10) means the type of cancer has a higher risk of growing and spreading. You typically get a Gleason score once, when you're first diagnosed with prostate cancer.
Why get a Gleason score? Your doctor will use your score along with the results of your PSA blood test and digital rectal exam to see how advanced your prostate cancer is and to recommend treatment.