On the Gleason:
During a biopsy a Gleason is graded on the worst sample taken. But the sample is only a small part of the actual tumor. After surgery the prostate is divided into sections. A new Gleason is assigned based on the worst section sampled. I know it's hard to describe but the Gleason during the biopsy is not necessarily the true picture. Sometimes it's down graded, too. But in Ricks and miy cases we were found to have a bit worse than thought.
On the Stage:
Almost none are Stage 3 or 4 in clinical staging unless more tests than a biopsy and a DRE are run. I was T1C after biopsy was positive and the DRE was negative. Because I was positive in the seminal vessicals I was pT3b after surgery.
There are two Types of staging. Clinical and Pathological.
In Clinical, Almost all who have has a negative DRE but a positive biopsy are T1C. But if the DRE is positive then you have at least Stage 2. Sonetimes more tests are run in possible high risk cases to see if it can be determined to be Stage 3 or 4. But not always.
In Pathological, which can only be performed after surgical removal of the prostate, Stage T1 is not used. The stage is now confirmed by appying ink and slicing the prostate for examination.
TX -- Primary tumor cannot be assessed
T0 -- No evidence of primary tumor
T1 -- Cannot detect tumor with imaging tests
T1a -- Less than 5 percent of the prostate is affected by the tumor
T1b -- More than 5 percent of the prostate is affected by the tumor
T1c -- Tumor identified by needle biopsy, PSA elevated
T2 -- Tumor confined within prostate
T2a -- Tumor affects one-half of one lobe or less
T2b -- Tumor affects more than one-half of one lobe but not both lobes
T2c -- Tumor affects both lobes
T3 -- Tumor extends through the prostate capsule
T3a -- Tumor extends beyond the prostate capsule
T3b -- Tumor invades seminal vesicle(s)
T4 -- Tumor is fixed or invades surrounding areas, such as the bladder neck, external sphincter, rectum, levator muscles, and/or pelvic wall
pT2 -- Tumor confined to the prostate
pT2a -- Tumor affects one-half of one lobe or less
pT2b -- Tumor affects more than one-half of one lobe but not both lobes
pT2c -- Tumor affects both lobes
pT3 -- Tumor extends beyond the prostate
pT3a -- Tumor extends beyond the prostate
pT3b -- Tumor invades seminal vesicle(s)
pT4 -- Tumor invades the bladder, rectum