What factors determine the aggressiveness of a prostate cancer?

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SandySrinivasMD (Physician - Oncology - Hematology/Oncology (Verified) ) - 12 / 03 / 2012

Typically when a patient is diagnosed with prostate cancer, several things are looked at. They include serum PSA, Gleason’s grade, and findings on a digital exam. Based on these 3 factors patients are classified as low, intermediate and high risk of having disease outside the prostate. Additional features include number of positive biopsies, number of biopsies with a high Gleason’s grade, % of tumor involved in each biopsy core. The rate of change of PSA within the last year is also helpful in determining aggressiveness. Having a Gleason’s grade of 4 or 5, or a PSA >20 or an abnormal rectal exam may determine that a patient has high-risk disease. These patients will get additional scans to ensure that the disease has not spread outside the prostate. Typically this group gets aggressive therapy with more than 1 mode of treatment such as surgery with or without radiation, or radiation with hormonal therapy.

Active research is ongoing evaluating biomarkers in blood and urine to determine if aggressiveness can be better determined when one is diagnosed with prostate cancer.
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