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Cancer Explained
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Prostate Cancer Stages and Grade

A plain-language explanation of how prostate cancer is staged and graded, including the Gleason score. Based on the National Cancer Institute.

NCI source

Last reviewed: 2026-07-07

The short answer

Prostate cancer is described by its stage (how far it has spread) and its grade, often as a Gleason score or Grade Group, which reflects how aggressive it looks. Together these guide treatment, including whether to treat right away.

  • Prostate cancer is described by both a stage and a grade.

  • Stage describes how far the cancer has spread, from confined to the prostate to distant spread.

  • Grade, shown as a Gleason score or Grade Group, reflects how aggressive the cancer looks.

  • Low-grade, low-stage cancers may be watched rather than treated right away.

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The full explanation.

The simple version

Prostate cancer is described in two ways: its stage (how far it has spread) and its grade (how aggressive it looks). Both matter, because some prostate cancers grow so slowly they can be watched rather than treated.

Stage and PSA

Staging describes whether the cancer is confined to the prostate, has grown just outside it, or has spread to lymph nodes or distant sites such as bone. The PSA blood level is considered along with the stage.

Grade and Gleason score

The grade, shown as a Gleason score or the simpler Grade Group (1 to 5), reflects how aggressive the cancer cells look under a microscope. A higher score means a more aggressive cancer.

Stage tells how far it has spread; grade tells how aggressive it looks.

Why it guides treatment

Together, stage and grade help predict how the cancer will behave. For low-grade, low-stage cancers, active surveillance — close monitoring — may be recommended, while higher-risk cancers may call for surgery or radiation.

Words to know

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Common questions

How is prostate cancer staged?

Staging describes whether the cancer is confined to the prostate, has grown just outside it, or has spread to lymph nodes or distant sites like bone. The PSA level is also considered.

What is the Gleason score?

The Gleason score, and the related Grade Group, describe how aggressive the cancer cells look under a microscope. A higher score means a more aggressive cancer.

What is active surveillance?

For low-grade, low-stage prostate cancer, active surveillance means closely monitoring the cancer with tests and treating only if it progresses. Many slow-growing prostate cancers can be safely watched.

Why do stage and grade matter?

Together they help predict how the cancer will behave and guide whether to watch it, treat it, and with what — from surveillance to surgery or radiation.

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Prostate Cancer Stages and Grade