Newly Diagnosed?
We Can Help Getting the correct diagnosis and the most appropriate treatment from the start is crucial 
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Biopsy
If a man's PSA level is elevated and digital rectal exam is abnormal, his physician is likely to suggest a biopsy. This is a procedure in which tissue samples are removed from the prostate and then examined by a pathologist. A biopsy can be performed in a urologist's office. Using a transrectal ultrasound (TRUS) probe, a physician can see the prostate and precisely place the biopsy needles to remove tissue from several different spots in the gland. Because the needles are inserted for only a fraction of a second, the procedure is essentially painless and takes about 20 minutes. During a standard biopsy, a physician removes six tissue samples. Researchers here are investigating ways to improve tissue sampling without using more needles.
If the results of the biopsy indicate that you do have prostate cancer, your physician will gather more information to further characterize the cancer and help determine the most effective course of treatment. In some cases, the physician may perform a second set of prostate biopsies for this purpose.
Gleason Grading System
Physicians characterize the aggressiveness of prostate cancer using the Gleason grading system, which provides an estimate of the cancer's potential to grow and spread to other parts of the body. The pathologist determines the Gleason grade based on how closely the cells of the gland resemble those of a normal prostate. A tumor whose cellular structure is close to normal is unlikely to be aggressively malignant and to spread -- and will be assigned a low combined Gleason score -- whereas a tumor that has little resemblance to a normal prostate is more likely to be aggressive and spread outside the prostate and will receive a high combined Gleason score (greater than or equal to 7.0). Memorial Sloan-Kettering's pathologists have an exceptional depth of expertise in analyzing prostate samples, and their skill is key in helping the other members of the prostate care team determine the most effective course of treatment for each patient.
Treatment is usually recommended for high-grade cancers, while observation may be recommended for low-grade cancers, especially when the patient is elderly or has other medical conditions.
