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How is it determined if a prostate cancer is low risk?
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StacyLoebMD (Physician - Urology (Verified) ) - 04 / 11 / 2012
Prostate cancer risk stratification is traditionally based on a combination of the PSA blood test, clinical stage (whether or not a tumor is felt on rectal examination), and the grade of the tumor on biopsy (Gleason score). In the most commonly used classification system, "low-risk" cancers are considered to be those with a PSA level <10 ng/ml, clinical stage ≤T2a, and Gleason score of 6 or less.
The National Comprehensive Cancer Network breaks this low-risk group down further into a “very low-risk” category. As in low-risk disease, tumors in this category all have PSA levels <10 ng/ml and a Gleason score of 6 or less. However, the “very low risk” category includes only nonpalpable tumors (clinical stage T1c) that are very low volume (present in fewer than 3 cores on biopsy, and which comprise no more than 50% of each biopsy core). Also, the PSA density (PSA level divided by prostate volume from the ultrasound) should be less than 0.15 ng/ml/g.
The National Comprehensive Cancer Network breaks this low-risk group down further into a “very low-risk” category. As in low-risk disease, tumors in this category all have PSA levels <10 ng/ml and a Gleason score of 6 or less. However, the “very low risk” category includes only nonpalpable tumors (clinical stage T1c) that are very low volume (present in fewer than 3 cores on biopsy, and which comprise no more than 50% of each biopsy core). Also, the PSA density (PSA level divided by prostate volume from the ultrasound) should be less than 0.15 ng/ml/g.
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