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Grading of the tumor is also essential, as treatment is often based on this information. The Gleason Grade is the most commonly used system to grade prostate tumors. It describes the degree of aggressiveness of the tumor by determining its degree of differentiation based on the appearance of the tissue under a microscope. The Gleason Grade does not determine how far the cancer has spread, whether it is confined to the prostate or to which part of the body the cancer may have spread, but it can be an indicator of how aggressive the cancer is or will behave in the future.

The Gleason Grade is the combination of two numbers, derived from adding the two highest grades assigned to two tissue areas extracted during the biopsy. The lowest possible Gleason Grade is 2 (1 + 1). The highest possible Gleason Grade is 10 (5 + 5). A high Gleason Grade (8-10) does indicate a greater chance that the cancer has spread beyond the prostate and is a more aggressive form of cancer. A very high Gleason Grade (i.e., 10) is strongly predictive for aggressive cancer that has likely grown outside of the prostate. Conversely, a lower Gleason Grade indicates a better prognosis.

The Whitmore-Jewett system is a staging system that uses the letters ABCD. The letters A and B refer to cancer that is confined to the prostate. The letter C refers to cancer that has grown beyond the prostate but has not spread to the lymph nodes or elsewhere in the body. The letter D refers to cancer that has spread to the lymph nodes or elsewhere in the body. An A designation in the Whitmore-Jewett system would correlates with Stage I Prostate cancer; B with Stage II; C with Stage III; and D with Stage IV.